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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700453
Report Date: 06/11/2024
Date Signed: 06/11/2024 11:13:09 AM

Document Has Been Signed on 06/11/2024 11:13 AM - 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 EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:WU, GUIZHENFACILITY NUMBER:
015700453
ADMINISTRATOR/
DIRECTOR:
GUIZHEN WUFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 876-7513
CITY:PLEASANTONSTATE: CAZIP CODE:
94566
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 3DATE:
06/11/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:15 AM
MET WITH:Guizhen WuTIME VISIT/
INSPECTION COMPLETED:
11:30 AM
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On June 11, 2024 at approximately 09:15 AM, Licensing Program Analyst (LPA) Lorraine Dacanay Breaux conducted an unannounced 1-Year Required Annual Inspection and met with licensee Guizhen Wu home and daughter Michelle Huang (translator/mandarin). LPA provided the LIC 126. LPA completed the staff interview with Licensee. The home was toured to conduct a Health and Safety Inspection. The Child Care home operates Monday - Friday 08:30AM - 5:30 PM. Living in the home is licensee Guizhen Wu and fingerprint cleared husband, Liping Lu.

This is a two story town home with 3 bedrooms and 2.5 bathrooms, living room, dining-room, kitchen and garage. The home appears to be neat and clean with heating and ventilation for safety and comfort.

ON LIMIT AREAS: Living Room, dining-room, half bathroom first floor, bedroom on the main level, and the rear/side yard. Isolation Area: Bedroom away from the children in care, until parents pick up.

OFF-LIMIT AREAS: Kitchen, entire 2nd level consisting of master bedroom and bathroom, 1 bedroom, 2 full bathrooms and two car garage. These areas will be off-limits by safety gates, closed locked doors and visual supervision. There is a safety gate at the base of the stairs and at the kitchen area to prevent children access to the off limit areas.

OUTDOOR SPACE: LPA toured the outdoor area (backyard). The yard is fully fenced. There are no swimming pool, hot tubs and/or any bodies of water during today's inspection. Licensee confirmed that she resides in the property. Licensee confirmed there are no swimming pool/hot tubs at the home. Licensee confirmed there are no fire arms at the home.

The home has a fully charged 2A10BC fire extinguisher located near the entry of the home, working smoke/carbon monoxide detector located in the hallway (tested), fully stocked first aid kit and working telephone. The home has a pull down fire alarm that has been approved by the Pleasanton Fire Department. There are age appropriate toys that appear to be safe and in good condition. LPA did not observe any hazardous materials or toxins accessible to children during today’s inspection. Licensee has child care liability insurance expires on 5/10/25.



See 809-C
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux
LICENSING EVALUATOR SIGNATURE: DATE: 06/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/11/2024
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 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: WU, GUIZHEN
FACILITY NUMBER: 015700453
VISIT DATE: 06/11/2024
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California Law requires Child Care licensees to report unusual incidents or injuries to children in care to child's parents and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624). Incidents must be reported within 24 hours by phone, fax, or electronic mail. Roster of the children must be properly maintained, and fire/disaster drill every six months must be documented.
CPR/First Aid is also renewed every two years. Baby bouncers & drop-down cribs are not allowed at the day-care facility.

LPA discussed the safe sleep regulations with facility representative 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 facility representative 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.



Per licensee does not administering medication.

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.

Licensee [or facility representative] was 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.



809-C
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux
LICENSING EVALUATOR SIGNATURE:

DATE: 06/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2024
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: WU, GUIZHEN
FACILITY NUMBER: 015700453
VISIT DATE: 06/11/2024
NARRATIVE
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The Licensee was also reminded that baby bouncers, exersaucers, johnny jumpers and similar items are not allowed in licensed day care. Licensee is reminded that when an assistant is not present she must operate as a small day care, caring for 6 children. Licensee is remind to keep the children files up to date and complete. Licensee is remind there is no smoking during child care operations hours at the facility.


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/process.

The licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

Megan’s Law: During the exit interview, the LICENSEE Guizhen Wu, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

No deficiencies found during today's inspection. One Advisory Note issued:

  • Advisory Note (TA): One child's file missing LIC9227, LIC 995 and LIC 613A

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. Appeal Rights provided. Exit interview conducted and report was reviewed with the licensee, Guizhen Wu.
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux
LICENSING EVALUATOR SIGNATURE:

DATE: 06/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2024
LIC809 (FAS) - (06/04)
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