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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434415424
Report Date: 07/20/2022
Date Signed: 07/20/2022 03:07:00 PM

Document Has Been Signed on 07/20/2022 03:07 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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:ORGANIZATION OF SPECIAL NEEDS FAMILIESFACILITY NUMBER:
434415424
ADMINISTRATOR:ALEJANDRA GOMEZFACILITY TYPE:
840
ADDRESS:511 S BASCOM AVE. (FRONT BLDG)TELEPHONE:
(408) 996-0850
CITY:SAN JOSESTATE: CAZIP CODE:
95128
CAPACITY: 6TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
07/20/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:25 PM
MET WITH:Lihuei YauTIME COMPLETED:
03:20 PM
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Licensing Program Analyst (LPA), Oscar Huang, conducted a screening call to licensee, Lihuei Yau for COVID-19 screening call right before the annual visit. Licensee stated that her facility was closed since March, 2020. Licensee stated she is currently not in the facility but that she can meet LPA at the facility for inspection in 20 minutes. When arrived, LPA toured the Facility both inside and outside during today's visit. The facility is serving school-age children ages 5 years to 17 years old.

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), and Activity Schedule. The Facility has no active waivers on file.

LPA reminded Director of the applicable civil penalties for those adults who have not received fingerprint clearances, are not associated to the facility 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 violation within a 12-month period. Licensee understands upon notice of the Department to remove or to exclude an individual from the facility, Director shall immediately remove the individual and prevent them from returning to the facility or having contact with children in care.

Licensee stated that all the staff were let go as all the clients had left in March, 2020. She will process the rehiring prior to reopen, and will be in compliance with regulations of staff requirements. LPA advised licensee that she can apply for an inactive request if she would like to for not opening.

SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Yangcheng Huang
LICENSING EVALUATOR SIGNATURE: DATE: 07/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/20/2022
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 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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: ORGANIZATION OF SPECIAL NEEDS FAMILIES
FACILITY NUMBER: 434415424
VISIT DATE: 07/20/2022
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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 the facility should always follow the CDC most recent guidance with state and county public health department.

LPA observed licensee's CPR & First Aid certification is current and expired on 7/2023.

Supervision of children was discussed with Licensee, and she understands that the staff must be present in the facility during day care hours and ensure that the children are supervised at all times. Licensee understands her capacity. Licensee states that she does not transport children via vehicle but she understands that children cannot be left in parked vehicles unattended at any time.

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. LPA observed licensee has completed her training and certification is on file 3/8/2022.

LPA reminded & discussed with licensee regarding water lead testing in center facility: In accordance with AB2370, all CCCs that were constructed before January 1, 2010 must test their water for lead by January 1, 2023, including CCCs located on school grounds.

It is the obligation of the CCC, not the landlord, to get the testing completed. The responsibility of payment for testing services may depend on the terms of their lease.

Based on the Written Directives outlined in PIN 21-21-CCP, all water that flows through the building service line or plumbing shall not be used during the stagnation period, which means that careful coordination will others who use the building is necessary to effectively prepare for the sampling event.



The Department does not make referrals to samplers. However, once the Department receives information from Certified External Water Samplers that wish to be listed, an ongoing list for public viewing will be located at this AB 2370 Sampler Directory, which currently includes samplers operating in every county in California.

No Deficiency was cited. Exit interview conducted with Licensee. A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE ENTRANCE TO THE HOME, AND MUST REMAIN POSTED FOR 30 DAYS.
SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Yangcheng Huang
LICENSING EVALUATOR SIGNATURE:

DATE: 07/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2022
LIC809 (FAS) - (06/04)
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