015700652-2-14-2025-52-CC-CCON-DDVV5N-20250214150812

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 015700652
Report Date: 02/14/2025
Date Signed: 02/14/2025 03:08:26 PM

Document Has Been Signed on 02/14/2025 03:08 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:	FRIENDS OF CHILDREN WITH SPECIAL NEEDS		FACILITY NUMBER:	015700652
ADMINISTRATOR/ DIRECTOR:	XIAOYAN LUO		FACILITY TYPE:	860
ADDRESS:	42080 OSGOOD RD SUITE 100		TELEPHONE:	(510) 739-6900
CITY:	FREMONT	STATE: CA	ZIP CODE:	94539
CAPACITY: 30	TOTAL ENROLLED CHILDREN: 30	CENSUS: 0	DATE:	02/14/2025
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	11:45 AM
MET WITH:	Anna Wong and Xiaoyan Luo		TIME VISIT/ INSPECTION COMPLETED:	03:21 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 Friday, February 14, 2025 at 11:45 AM, Licensing Program Analyst, (LPA) Caroline Colson met with Applicant Anna Wong and Xiaoyan Luo, Center Director for a change of location prelicensing inspection. The applicant requests 30 school age children from 5 years of age to 18 years of age. A health and safety inspection in all areas accessible to children was conducted. There are no children present. The facility will operate Monday through Friday from 12:00 PM to 6:00 PM. Physical Plant: The facility has five (5) classrooms and an outdoor play area. There is adequate heating, lighting, and ventilation. There are no cleaning solutions, chemicals, or other hazards accessible to children. Per Applicant, there are no weapons at the facility. Classrooms: There are separate storage areas for children’s belongings. Bottle water will be available for all students during indoor and outdoor activities. Children do not take naps at the facility. There are 3 first aid kits and 6 emergency disaster boxes. The facility will only be providing afternoon snack. Please See LIC 809 for Additional Information

SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Caroline Colson
LICENSING EVALUATOR SIGNATURE:	DATE: 02/14/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2025

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

LIC809 (FAS) - (06/04)

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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: FRIENDS OF CHILDREN WITH SPECIAL NEEDS	FACILITY NUMBER: 015700652
	VISIT DATE: 02/14/2025

NARRATIVE

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Restrooms: Toilets and sinks are operable. There is soap, toilet paper and paper towels for sanitary use.

Classroom measurements:
LPA measured five (5) classrooms for the School Age Component. The total indoor measurements for school age children is 1454.06 square feet which will accommodate Applicant's request for 30 children.

There are a total of three (3) toilets, one (1) urinal and two sinks for the children. Classroom 104 (a) will be the isolation area. The isolation bathroom will be one of children's stall. The staff bathroom is located outside of classroom 101.

Outdoor Activity Space:
The outdoor play area is fenced by the building walls and walls are at least 4 ft tall. There are no bodies of water on the premises. Playground is free of debris and other hazards. Children will have access to drinking water. The total outdoor play area measurements for the outdoor play area is 1713.32 square feet which not will accommodate Applicant's request for 30 school children.

See LIC 809 C for Additional Information

SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Caroline Colson
LICENSING EVALUATOR SIGNATURE:	DATE: 02/14/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2025

LIC809 (FAS) - (06/04)

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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: FRIENDS OF CHILDREN WITH SPECIAL NEEDS	FACILITY NUMBER: 015700652
	VISIT DATE: 02/14/2025

NARRATIVE

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Emergency Preparedness/Safety: Emergency Disaster Plan is dated and posted for review. The facility utilizes a land line telephone and cell phones. Fire Clearance was received on June 3, 2024.

Licensee was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

LPA advised per Health and Safety Code 1597.16(a)(1) Lead Testing and PIN-21-21-CCP Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010 to test their drinking water for lead contamination between January 1, 2020 and January 1, 2023, and then every 5 years after the date of the first test.

Per Written Directive 100700(c)(1) Written Directives for Lead Testing (1) For a license issued on or after July 1, 2022, initial testing results shall be received and posted within 180 days of licensure. LPA discussed the safe sleep regulations with Applicant and discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed Applicant 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.

Please See LIC 809 C for Additional Information

SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Caroline Colson
LICENSING EVALUATOR SIGNATURE:	DATE: 02/14/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2025

LIC809 (FAS) - (06/04)

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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: FRIENDS OF CHILDREN WITH SPECIAL NEEDS	FACILITY NUMBER: 015700652
	VISIT DATE: 02/14/2025

NARRATIVE

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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes 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 ADA, available at http://www.ada.gov/childqanda.htm

LPA reviewed with Applicant the LIC 311 A, Records to Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

LPA discussed 100% supervision is always required in all areas that children have access to including the bathroom. Personal Rights, inspection authority, reporting requirements, maintaining buildings and grounds was reviewed. Staff Qualifications, Staff to Children’s ratios and Capacity was explained to ensure compliance. LPA discussed with Applicant any changes that may occur regarding the director or an employee acting in the director's absence must be reported to department within 10 working days.

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

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms.

To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Caroline Colson
LICENSING EVALUATOR SIGNATURE:	DATE: 02/14/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2025

LIC809 (FAS) - (06/04)

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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: FRIENDS OF CHILDREN WITH SPECIAL NEEDS	FACILITY NUMBER: 015700652
	VISIT DATE: 02/14/2025

NARRATIVE

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Exit interview was conducted with Applicant Anna Wong and Center Director Xiaoyan Luo

The following items are required before a license will be issued:

1. Applicant will need to purchase a thermometer for a First Aid Kit.
2. Applicant will need to label one of the children's bathroom stalls as an isolation bathroom.
3. Applicant will need to create a snack menu from two food groups and post.
4. Applicant will need to create shade for the outdoor play area.
6. Applicant will need to submit a waiver for the outdoor play area.
7. Parent Handbook will need to be updated.
8. The classrooms will need to be set up for the children.
9. Play equipment will need to be available for the outdoor play area.
10. Food will need to be purchased.
11. Sign In and Sign Out sheets need to be updated.
12. Admission Agreement will need to be updated online for parents.
13. Applicant will ensure that all staff are qualified staff.

Once we receive the above items, the facility can be licensed as a Single License facility.

SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Caroline Colson
LICENSING EVALUATOR SIGNATURE:	DATE: 02/14/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2025

LIC809 (FAS) - (06/04)

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