015700374-8-30-2024-52-CC-RMIA-D8MVT6-20240830164238

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 015700374
Report Date: 08/30/2024
Date Signed: 08/30/2024 04:42:45 PM

Document Has Been Signed on 08/30/2024 04:42 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	HSIEH, HSIN-CHIA & MAO, YING-LI		FACILITY NUMBER:	015700374
ADMINISTRATOR/ DIRECTOR:	MAO, YING LI & HSIEH, HSIN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 905-9682
CITY:	FREMONT	STATE: CA	ZIP CODE:	94536
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 10	DATE:	08/30/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:42 PM
MET WITH:	Hsin-Chia Hsieh & Ying-Li Mao		TIME VISIT/ INSPECTION COMPLETED:	04:45 PM

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25

On August 30, 2024 at approximately 1:42pm Licensing Program Analyst (LPA) Randy Miranda arrived unannounced to meet with licensee Hsin-Chia Hsieh and Ying-Li Mao for the purpose of conducting an annual inspection for Health and Safety. Present in the home today were licensees Ying-Li Mao and Hsin-Chia Hsieh, their 5-year old daughter and 9 other children in care (1 four years old; 3 three years old; 3 two years old; 2 one year old). Hours of operation are Monday – Friday 8:30am to 5:00pm.

The facility is a single-story home with 5 bedrooms and 2 ½ bathrooms; a living room (with a screened fireplace); kitchen; dining room; family room (day care area); attached 2-car garage; side and backyard area. There is a six-foot fence surrounding the perimeter of the backyard with a single swinging gate for access on the east side. There is an old non-functioning wall heater in the on-limits living room with a waiver requiring it not to be in used during operation of the day care and remain cool to the touch.

Per the licensees’, the ISOLATION AREA will be in the Living Room near the daycare area away from the other children in care.

On-limit areas include: Living room; family room (day care area); kitchen; dining room; and bathroom on the right side of the hall just outside of the family room; the side and backyard areas outside.

Off-limit areas include: 5 Bedrooms down the hall on the right side of the living room; house bathroom and master bathroom and hallway leading to these bedrooms and bathrooms (there is a child gate to prevent access where the hallway meets the living room); bedroom / office on the left side of the hall just off the family room; the 2-car garage; and two small storage sheds on the west side of the backyard, All off limit areas are inaccessible by closed and/or locked doors and visual supervision.

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Randy Miranda
LICENSING EVALUATOR SIGNATURE:	DATE: 08/30/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 4

Document Has Been Signed on 08/30/2024 04:42 PM - It Cannot Be Edited

Created By: Randy Miranda On 08/30/2024 at 04:01 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: HSIEH, HSIN-CHIA & MAO, YING-LI	FACILITY NUMBER: 015700374
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/30/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102417(g)(4)

(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above in that child-proof latches have worn out and/or are not functioning properly which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/13/2024
	Plan of Correction
1 2 3 4	Licensees to purchase new latches and install them on the doors under the kitchen sink and drawer next to the stove (or move sharp utensils to an upper cabinet). Email pictures of new locks to LPA as proof of correction.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME:

Wynn Norona

LICENSING EVALUATOR NAME:

Randy Miranda

LICENSING EVALUATOR SIGNATURE:

DATE: 08/30/2024

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2024

LIC809 (FAS) - (06/04)

Page: 2 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: HSIEH, HSIN-CHIA & MAO, YING-LI	FACILITY NUMBER: 015700374
	VISIT DATE: 08/30/2024

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

There are play structures in the back yard: a swing set; additional play structure with slides; and climbing monkey bars dome and a small playhouse. All items were observed to be safe and in good condition.

The home and the day care area and rooms are neat and clean, with heating and ventilation for safety and comfort and ample age-appropriate toys. LPA did not observe any hazardous materials, or toxins accessible to children on the premises during the inspection, however, the child-proof lock on the kitchen drawer with sharp utensils has worn out. The child-proof lock on drawer is worn out, therefore drawer is accessible to children– see LIC809D for deficiency.

There is a fully charged 2A10BC fire extinguisher located in the kitchen. The facility has working (tested and functioning) combined smoke and carbon monoxide detector. The last fire drill was completed on 08/2024. Per licensees’, there are no firearms in the home.

Licensees’ Pediatric CPR/First Aid certificates are current and expire on 08/10/2026. Mandated Reporter certificate expire for both licensees on 06/28/2025. Preventative Health and safety have been completed, including the lead poisoning prevention training. LPA reminded the licensees’ of the following: Mandated Reporter training is to be renewed every two years; CPR/First Aid is also renewed every two years. Baby bouncers & drop-down cribs are not allowed at the day-care facility

Licensees’ rent the property and has childcare liability insurance with Next Insurance company, the policy expires in 07/14/2025.

Children’s files were reviewed, a copy of the roster was taken by the LPA for the office file. All other files were complete and in good order. There are two infants in care at this time and infant safe sleep plans/safe sleep logs are current.

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Randy Miranda
LICENSING EVALUATOR SIGNATURE:	DATE: 08/30/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2024

LIC809 (FAS) - (06/04)

Page: 3 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: HSIEH, HSIN-CHIA & MAO, YING-LI	FACILITY NUMBER: 015700374
	VISIT DATE: 08/30/2024

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

LPA reviewed the safe sleep regulations with licensees’ and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensees’ of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Licensees’ were reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

A deficiency was issued this day – See LIC809D. This report will remain on file for 3 years.

A notice of site visit was given and must remain posted for 30 days. Appeal Rights provided.

Exit interview conducted and report was reviewed with licensee Ying-Li Mao and Hsin-Chia Hsieh.

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Randy Miranda
LICENSING EVALUATOR SIGNATURE:	DATE: 08/30/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2024

LIC809 (FAS) - (06/04)

Page: 4 of 4