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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434413108
Report Date: 09/01/2021
Date Signed: 09/01/2021 11:04:36 AM

Document Has Been Signed on 09/01/2021 11:04 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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:ACADEMY OF MANDARIN IMMERSIONFACILITY NUMBER:
434413108
ADMINISTRATOR:CHIA YI LIFACILITY TYPE:
850
ADDRESS:3257 PAYNE AVENUETELEPHONE:
(408) 691-3808
CITY:SAN JOSESTATE: CAZIP CODE:
95117
CAPACITY: 23TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
09/01/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH:Chia Yi LiTIME COMPLETED:
11:20 AM
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Licensing Program Analyst (LPA), Oscar Huang, conducted an unannounced annual/random inspection to the facility today. LPA met with Director, Chia Yi Li, and explained the nature of today's inspection to her. LPA toured the facility both inside and outside during today's inspection. LPA observed the required posted materials, including the Facility License, Emergency Disaster Plan (LIC 610), Earthquake Preparedness Checklist (LIC 9148), Parents' Rights Poster (PUB 393), Personal Rights (LIC 613A), Child Car Seat Law (PUB 269), Menus includes current and following weeks and Activity Schedule. LPA observed 4 staff with no daycare children as the facility is closed for annual cleaning, only teachers were present.

A review of staff records on today indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. LPA reminded her of the applicable civil penalties for those adults who have not received fingerprint clearances, are not associated to the license and who come in contact with or provide care and supervision to the children. Penalty amounts: $100.00 per person per day, minimum of $100.00 to a maximum of $500.00 per person for an initial violation and a minimum of $100.00 to a maximum of $3000.00 per person for any subsequent violations within a 12-month period. Director understand upon notice of the Department to remove or to exclude an individual from the facility, she shall immediately remove the individual and prevent them from returning to the facility or having contact with children in care.

LPA reviewed 8 children and 4 staff files. Each child's file reviewed contains the Information and Emergency Information form (LIC 700), a copy of the admission agreement, Notification of Parent's Rights, and Personal Rights, and Physician Report. Immunization records were also updated. LPA observed that all children were properly signed in and out by a parent or authorized representative. All staff files reviewed contain the required transcripts/verification of experience. LPA observed all staff have current CPR and First Aid certifications on file. LPA observed that the teacher/child ratio was in compliance during today's visit. Director understands the conditions, limitations, and capacity specifications of the Facility license, and children shall be visually supervised at all times.

LPA observed that all preschool rooms are under cleaning. Drinking water is readily available for the children via school provided filtered water, and can be refilled both outdoor & indoor. LPA observed solid waste containers with tight-fitting lids in each room. Staff and children's bathrooms are clean, sanitary, and operable.


Facility Evaluation Report dated 09/01/2021 to be continued on next page:
SUPERVISORS NAME: Sandy Knight
LICENSING EVALUATOR NAME: Yangcheng Huang
LICENSING EVALUATOR SIGNATURE: DATE: 09/01/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/01/2021
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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: ACADEMY OF MANDARIN IMMERSION
FACILITY NUMBER: 434413108
VISIT DATE: 09/01/2021
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There is a separate staff bathroom in the office not utilized by the children which an isolated child can use if needed. Director stated that there are no weapons or firearms on the premises. LPA observed sufficient mats for the children. Director stated that bed sheets are taking home washed every Friday.

The facility provides lunch and snacks to the children. All food is in kitchen and are current. The food preparation and storage areas are clean, free of litter & rubbish, and free of rodents and other vermin. All food and beverages that require refrigeration are stored in covered containers at 45 degrees F or less. Cleaning supplies are inaccessible to the children and stored in locked kitchen cabinets inaccessible to children. Any medications at the facility are stored in the office. LPA observed all furniture and equipment are in good condition and safe for the children. The playground areas utilized by the preschool children is surrounded by appropriate fencing. LPA observed that the outdoor equipment is age appropriate and in good condition. LPA observed that there is sufficient rubber tan bark resilient materials around and under the play structures in the playgrounds, shade is provided by trees and building over hangs. LPA did not observe any bodies of water in the playground area.

LPA discussed AB 2231: Civil Penalty Updates effective July 1, 2017 with director. A $500 immediate civil penalty and $100 per day violation until corrected is assessed for serious violations such as absence of supervision, accessible bodies of water, accessible firearms, refused entry of licensing staff, presence of an excluded person, and violations that result in illness or injury. A $100 per day for each violation for Failure to Correct, and $250 immediately and $100 per day per violation until corrected for Repeat Violations. LPA observed staff have all the immunization records in file per SB 792 Immunization Requirements. Incidental Medical Services (IMS) were discussed with Licensee/Director. The facility provides Epinephrine Auto-Injector & Inhaled Medications IMS, but does not have any children enrolled at this time required the services. 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

LPA reviewed COVID-19 infection prevention guidance & self-assessment with licensee including her plans in place to protect and support staff, children, cleaning & hygiene implementation, health screening & social distancing practices, meal times and arrival & pickup procedures. LPA observed posters & visitor policy notice were posted at the front entrance. LPA advised that all children above 2 were wearing masks.



LPA also reminder Director regarding AB 2370 required child center to to test contamination between Jan. 1, 2020 to Jan. 2023, and information was also published on PIN 21-21-CCP.

LPA discussed Beginning January 1, 2018, Health and Safety Code 1596.8662 requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. The training web site is available at: http://www.mandatedreporterca.com. LPA observed all the staff had completed their training on 08/07/2021, and their certification are on file.

No Deficiency is cited. Exit interview conducted with Director. A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE ENTRANCE TO THE HOME, AND MUST REMAIN POSTED FOR 30 DAYS.

SUPERVISORS NAME: Sandy Knight
LICENSING EVALUATOR NAME: Yangcheng Huang
LICENSING EVALUATOR SIGNATURE:

DATE: 09/01/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2021
LIC809 (FAS) - (06/04)
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