414004642-10-18-2022-05-CC-CQUO-CKBNTQ-20221018104503

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414004642
Report Date: 10/18/2022
Date Signed: 10/18/2022 10:45:37 AM

Document Has Been Signed on 10/18/2022 10:45 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, 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: 12	CENSUS: 10	DATE:	10/18/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:20 AM
MET WITH:	Fenge "Jenny" Ye		TIME COMPLETED:	11:00 AM

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 October 18, 2022 at approximately 8:20am, Licensing Program Analyst (LPA) Catrina Quimbo conducted an unannounced, annual inspection. LPA met with licensee, Fenge "Jenny" Ye, and explained the purpose of the inspection. On October 8, 2022, licensee requested to expand portions of backyard as part of day care areas. LPA's visit today also included a case management inspection to include the backyard area as a day care area. Present during LPA's visit included 10 enrolled children (3 infants and 7 preschool age), licensee and licensee's two assistants (A1 and A2). Licensee is operating within capacity limits and ratio during LPA's visit. Hours of operation are Monday to Friday from 8:00am to 6:00pm. Licensee lives in the home with their spouse, adult child, and two minor children. All adults living and/or working in the home have fingerprint clearance on file. The home is a single level home that includes three bedrooms, two bathrooms, family room/sun room, living room, dining area, kitchen, garage, side yard, deck area, and backyard. The DAY CARE AREAS now approved are the family room/sun room (main classroom), bathroom #1 (located in main classroom), master bedroom (converted into second classroom/napping room), side yard, deck (located in backyard), and portion of backyard. The OFF LIMIT AREAS are bedroom #1, bedroom #2, living room, dining area, kitchen, garage, and portion of backyard. All off limit areas are properly barricaded with child safety gates, child safety handles and/or locked doors. The portion of the backyard that remains off limits includes a fish pond. The off limit area of backyard is fully gated by a fence that is at least 6ft. tall with a self latching gate. (Continue Report on Page 2...)

SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 10/18/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2022

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: 10/18/2022

NARRATIVE

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At approximately 8:45am, LPA inspected day care areas, inside and outside, for health and safety hazards. LPA observed the deck and backyard area to be added as a day care area to be equipped with age appropriate materials that were in good condition. Backyard includes a play structure that was observed to have resilient padding underneath. Backyard also includes a grill that is properly barricaded from children. Licensee plans to utilize deck as an additional space for children's lessons and/or play area. Deck is fully fenced and observed to be safe. Both side yard and backyard were observed to be clean and equipped with children's toys that were in good working condition.

LPA observed home to be in good repair with proper temperature and ventilation. There were a variety of toys and equipment in the home that were age appropriate. LPA observed electrical outlets located in day care areas to be made inaccessible by child safety covers. LPA observed all cleaning supplies, poisons, and other chemicals to be stored inaccessible in home's high shelves and/or locked behind child safety locked cabinets.

Home has multiple carbon monoxide and smoke detectors, fully charged fire extinguisher and a working phone on site. Phone number listed for licensee is current. Licensee maintains a firearm that is stored in an off limit room. LPA observed the off limit room to be fully locked that requires a key which is stored in a separate off limit room.

LPA observed required licensing documents to be properly posted, available for review. LPA reviewed 10 children's records which were complete. Children's files have a record of emergency identification information on file. LPA reviewed licensee, A1 and A2's files which were also complete. Licensee and assistants have a record of required immunization on file, current Mandated Reporter training certificates and current CPR certificates. Licensee's CPR certificate will expire 07/2023. Licensee reminded licensee Mandated Reporter training certificate and CPR certificate must be renewed every 2 years. Licensee is aware Mandated Reporter certificate must be maintained for all staff hired.

Last emergency drill was conducted 10/17/2022. Emergency drills are conducted at least once every six months and are properly logged. Licensee also maintains safe sleep logs for napping infants in care. Sleeping logs include and document the 15 minute time checks of when infant was last checked on while sleeping and which assistant checked on napping infant.
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SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 10/18/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2022

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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: YE, FENGE	FACILITY NUMBER: 414004642
	VISIT DATE: 10/18/2022

NARRATIVE

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This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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

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.

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.

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: 10/18/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2022

LIC809 (FAS) - (06/04)

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