414004642-11-23-2021-05-CC-CQUO-C92RV6-20211123122057

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414004642
Report Date: 11/23/2021
Date Signed: 11/23/2021 12:21:55 PM

Document Has Been Signed on 11/23/2021 12:21 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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	YE, FENGE		FACILITY NUMBER:	414004642
ADMINISTRATOR:	YE, FENGE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(415) 307-3838
CITY:	SAN MATEO	STATE: CA	ZIP CODE:	94403
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 11	CENSUS: 9	DATE:	11/23/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Licensee, Fenge Ye		TIME COMPLETED:	12:30 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 November 23, 2021 at 10:00am, Licensing Program Analyst (LPA) Catrina Quimbo conducted an unannounced, annual, required inspection. LPA met with licensee, Fenge "Jenny" Ye. Licensee is licensed for a Large Family Child Care home as of 1/07/2021. Present during the inspection was licensee's spouse, licensee's two minor children, two helpers (H1 and H2), and 9 enrolled children (3 infants and 6 preschool age). Licensee is operating within capacity requirements on this date. All adults living or working in the home have criminal record clearance on file. Hours of operation are Monday to Friday from 7:30am to 6:00pm. Licensee owns the home which is single level, family home. The home consists of three bedrooms, two bathrooms, a family room, sun room, living room, dining room, kitchen, garage and side/backyard. The DAY CARE AREAS are the family room (main classroom), bathroom (located in main classroom), master bedroom (napping room), sun room (classroom #2), and side yard. The OFF-LIMIT AREAS are bedroom #1, bedroom #2, living room, dining room, kitchen, garage and portion of backyard. All off limit areas are properly barricaded with child safety gates, child safety handles, and/or locked doors. At approximately 10:15am, LPA toured day care areas of home with Licensee. LPA observed home to be in good repair with proper temperature and ventilation. There were a variety of age appropriate toys and equipment in the home which were in good condition. Bodies of water on site were located in off-limit areas, completely separate, fenced and inaccessible to enrolled children in care. The entire backyard is enclosed with an least 5ft high fence. Backyard is equipped with appropriate outdoor toys and equipment that are in good working condition. All cleaning supplies, poisons and other chemicals were stored inaccessible to children on high shelves. (Continue on Page 2...)

SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 11/23/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/23/2021

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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: YE, FENGE	FACILITY NUMBER: 414004642
	VISIT DATE: 11/23/2021

NARRATIVE

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There was a working smoke detector and carbon monoxide detector, a fully charged fire extinguisher and a working telephone on site. Phone number listed for Licensee is current. LPA reviewed eleven children’s records which were complete. Children’s files have a record of emergency identification information on file. LPA reviewed Licensee, H1's and H2's files which were complete. H1 and H2 have record of immunizations, valid First Aid/CPR and Mandated Reporter certificates that will expire 07/2023. Licensee's Pediatric First/Aid CPR certificate is current and will expire July 2023. Last emergency drill conducted was 10/18/2021 and is properly logged. LPA reviewed facility's safe sleep logs for napping infants. Safe sleep logs are documented, maintained and properly logged for each napping infant.

During Inspection:
- Licensee was given information regarding CA DPH Guidance for Use of Face Coverings, Receiving Important Updates, and Lead Poisoning Facts Flyer.
-Licensee was reminded, as of September 1, 2016, all Staff and Volunteers must provide proof of immunization against pertussis, measles, and influenza, or qualifies for an exemption, pursuant to Health and Safety code 1596.7995 and 1597.622.
-Licensee was reminded, frequent Visitors or Volunteers must be fingerprint cleared and associated to facility.
-Licensee was reminded about Mandated Reporter training available on CCLD website. Training must be completed every 2 years by all staff hired. Training can be taken online at www.mandatedreporterca.com.
-Licensee was reminded about the Provider Information Notices (PINs) on CCLD website.
-Licensee was advised for any additional questions to contact CCLD office, Monday to Friday, 8:00am - 5:00pm, (650) 266-8800 or 1 (844) 538-8766. Website: www.cdss.ca.gov.

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: www.ada.gov/childqanda.htm

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SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 11/23/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/23/2021

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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: YE, FENGE	FACILITY NUMBER: 414004642
	VISIT DATE: 11/23/2021

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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.

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.

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.

No deficiencies were cited today under CCR, Title 22, Div. 12, Chapt. 1.

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

An exit interview conducted and report was reviewed with the licensee, Fenge "Jenny" Ye.

SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 11/23/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/23/2021

LIC809 (FAS) - (06/04)

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