<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423630
Report Date: 03/29/2021
Date Signed: 03/29/2021 03:08:42 PM

Document Has Been Signed on 03/29/2021 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
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:HUANG, CUILINGFACILITY NUMBER:
013423630
ADMINISTRATOR:HUANG, CUILINGFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 417-6591
CITY:ALAMEDASTATE: CAZIP CODE:
94501
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
03/29/2021
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Cuiling HuangTIME COMPLETED:
03:15 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 3/29/21 at 1:45pm, Licensing Program Manager (LPM) Loretta Dyson conducted a prelicensing inspection with the applicant, Cuiling Huang. The applicant's child was also present. The applicant submitted an initial application for a large family child care home license, after being licensed in another location previously. The facility will operate Monday-Friday 7:00am-6:00pm. A tour of the home was completed to conduct a health and safety inspection.

The home is a single story home, with sufficient heating and ventilation for safety and comfort. The home consists of three bedrooms, two bathrooms, living room, family room, den, kitchen, covered sun room, and garage. The on limit areas include the living room, den, kitchen, family room, bathroom to the right of the front door and covered sun room. All other areas are off limits and made inaccessible by closed and/or locked doors and visual supervision. The isolation area will be the living room, family room or covered sun room, away from other children in care. The licensee advised that this will depend on the number of children in care and the activities they have planned. LPM observed an ample supply of age appropriate toys, furniture and activities. LPM did not observe any bodies of water, toxins or hazardous items that would be accessible to children. The backyard is fully fenced and LPM did not observe any defects of dangerous conditions. There are two storage units in the backyard, which are locked. There are no firearms in the home, per the applicant.

The home has a fully charged 3A40BC fire extinguisher, working combination smoke/carbon monoxide detector, working telephone, and first aid kit. The applicant has completed the required preventative health and safety training, which includes the nutrition and lead poisoning prevention requirements, and has a current CPR/First Aid certificate that expires on 11/7/22. The applicant has provided proof of control of property.

LPM verified that the applicant has all of the required postings. The applicant was reminded to ensure that parents have access to the information. LPM reviewed safe sleep regulations and advised the applicant that a pack-in-play should only be for play and not sleep.
SUPERVISORS NAME: Diane Perez
LICENSING EVALUATOR NAME: Loretta Dyson
LICENSING EVALUATOR SIGNATURE: DATE: 03/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/29/2021
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 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: HUANG, CUILING
FACILITY NUMBER: 013423630
VISIT DATE: 03/29/2021
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
The applicant is reminded of the following: to review and follow COVID-19 guidelines, to report any injuries or unusual incidents, including COVID-19 exposures and positive results at the facility. The applicant is advised to review licensing regulations and guidelines, including the Provider Information Notices (PINs) on the website www.ccld.ca.gov and to sign up to receive quarterly updates by email by sending a request to ChildCareAdvocatesProgram@dss.ca.gov.

Incidental Medical Services (IMS) policy was discussed. 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 is reminded that ALL assistants, volunteers, frequent visitors, or adults living in the home, that are 18 years of age or older must be fingerprint cleared and associated to this facility prior to being in the presence of children in care or an immediate civil penalty will be assessed from $100 to $3000 per person, per incident. LPM reviewed the individuals associated to the license, and the licensee confirmed that everyone who is required to have a criminal record clearance is associated. Licensee was reminded of the responsibility as a mandated reporter. The licensee was reminded that the mandated reporter training needs to be renewed every 2 years, at www.mandatedreporterca.com.

LPM reviewed the ratio and capacity for a large family child care home license, and reminded the applicant to adhere to these requirements at all times.

This home will be licensed effective today, 3/29/21. An exit interview was conducted with the applicant. This report will remain on file for 3 years.
SUPERVISORS NAME: Diane Perez
LICENSING EVALUATOR NAME: Loretta Dyson
LICENSING EVALUATOR SIGNATURE:

DATE: 03/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2021
LIC809 (FAS) - (06/04)
Page: 2 of 2