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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700366
Report Date: 10/27/2022
Date Signed: 10/27/2022 11:06:11 AM

Document Has Been Signed on 10/27/2022 11:06 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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:LIU, LING CHUFACILITY NUMBER:
015700366
ADMINISTRATOR:LIU, LING CHUFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 398-7038
CITY:FREMONTSTATE: CAZIP CODE:
94536
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
10/27/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Ling Chu LiuTIME COMPLETED:
11:10 AM
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On October 27, 2022 at approximately 8:00am Licensing Program Analyst (LPA) Russ Haderer met with licensee Ling Chu Liu for the purpose of conducting an announced pre-licensing / change of location inspection. The new CARE tool was used. Living in the home is the licensee, her TB test and fingerprint cleared adult sons and adult daughter. Present in the home at the time of inspection was the licensee and one of her adult sons. The hours of operation will be Monday-Friday, 9:00am to 6:00pm.

The facility is a two-story home with 5 bedrooms and 3 bathrooms; a family room (with a fully screened fireplace); living room; utility room (converted to childcare room); kitchen; dining room; laundry room, attached 2-car garage; side and backyard patio areas. There is a child gate at the bottom of the stairs preventing children from accessing the upstairs areas. The backyard contains 2 sheds, a covered and locked jacuzzi and a large patio area. There is a six-foot wood fence surrounding the backyard with gates for emergency egress.



Toxins, medicines, and hazardous items were inaccessible during today's inspection. Per the licensee, the ISOLATION AREA will be in utility room daycare area away from the other children in care.

On-limit-areas include: Living room (day care area); family room; dining room; utility room (day care area on left side of the kitchen); the first floor bedroom on the right side of the living room; first floor full bathroom; outside main patio area off the family room on the east side of the of the home.

Off-limit-areas include: The entire upstairs; kitchen (there is a child gate installed to prevent children from access); the attached 2-car garage; outside side yards (north and south patio areas); both sheds and a swing set (2 swings) on western side of back yard. All off limit areas will be inaccessible by closed and/or locked doors and visual supervision.
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE: DATE: 10/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/27/2022
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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: LIU, LING CHU
FACILITY NUMBER: 015700366
VISIT DATE: 10/27/2022
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There were ample age appropriate toys that 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. LPA did not observe any hazardous materials, or toxins accessible to children on the premises during the inspection.

There are two fully charged 3A40BC fire extinguishers, one is wall mounted by the front door and the second one wall mounted near the kitchen. There is an additional 2A10BC located in the garage. The facility has multiple working (tested and functioning) smoke and carbon monoxide detectors. Fremont Fire Department granted the fire clearance on October 20, 2022, only restriction noted; daycare not permitted in garage or second floor. There are pull down fire alarms present in the home. Per licensee, there are no firearms in the home.

The licensees Pediatric CPR/First Aid certificate is current and expires 3/06/2023. Mandated reporter training was completed on 2/04/2021. Licensee’s primary helper (son Christopher) CPR/1st Aid expires 9/04/2023 and Mandated Reporter training completed 8/07/2021. Licensee and helper are in compliance with all immunization laws required for child care providers.

LPA reminded the licensee 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.

The licensee rents the property and carries childcare liability insurance through Northfield Insurance Company St. Paul MN, policy expires 2/02/2023. LIC9151 Property Owner Notification form completed and signed 8/31/2022.

LPA discussed the safe sleep regulations with licensee 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 licensee 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.
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE:

DATE: 10/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2022
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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: LIU, LING CHU
FACILITY NUMBER: 015700366
VISIT DATE: 10/27/2022
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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 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.

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.

The home is recommended for licensing as of this day October 27, 2022. This report will remain on file for 3 years.

Exit interview conducted and report was reviewed with the licensee Ling Chu Liu.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE:

DATE: 10/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2022
LIC809 (FAS) - (06/04)
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