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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434415687
Report Date: 11/26/2024
Date Signed: 11/26/2024 03:12:44 PM

Document Has Been Signed on 11/26/2024 03:12 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
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:HUANG, XUECONGFACILITY NUMBER:
434415687
ADMINISTRATOR/
DIRECTOR:
HUANG, XUECONGFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 627-6848
CITY:PALO ALTOSTATE: CAZIP CODE:
94303
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 8DATE:
11/26/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:20 PM
MET WITH:Xuecong HuangTIME VISIT/
INSPECTION COMPLETED:
03:30 PM
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On 11/26/2024 at 1:20pm, Licensing Program Analyst (LPA) Jialing “Julianne” Zhu met with licensee Xuecong Huang for an unannounced annual inspection. Also present during the inspection were two (2) fingerprint-cleared assistants, and eight (8) children (6 preschool-aged and 2 infants) in care. The licensee is within ratio and in compliance with capacity regulations today. Upon arrival, LPA provided licensee a copy of the Entrance Checklist (LIC 126). The home was toured to conduct a Health and Safety Inspection. The facility’s current hours of operation are Monday - Friday from 9:00am - 6:00pm.

The facility is a single-story home. The on-limit areas are the master bedroom and bathroom, combination living room and dining room, and backyard. The off-limit areas are kitchen, bedrooms 2, 3, & 4, bathroom (next to bedroom 4), garage, and the sides of the backyard, which are inaccessible by closed and/or locked doors, barricades, and visual supervision. The isolation area is the dining room, where a table and chair is set up. When a child shows signs of illness, he/she will be separated from other children here.

The inside of the home is observed to be clean and orderly, with central heating and ventilation for safety and comfort. LPA observed there are ample safe and age-appropriate toys, play equipment and materials. All toxins, cleaning products, and hazardous materials have been made inaccessible to the children. Licensee does not provide transportation.

There is a fully charged 3A40BC fire extinguisher in the kitchen. There are smoke and carbon monoxide detectors located through the facility. LPA observed at least one (1) smoke detector and carbon monoxide detector is in working order. The home is equipped with telephone service and a fully stocked first aid kit. Per licensee, there are no firearms on premises. The licensee conducts and documents fire and disaster drills at least once every six months, and the last conducted drill was on 08/12/2024. All required documents are posted and visible for public review.

Page 1 of 3. See LIC 809C.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Jialing Zhu
LICENSING EVALUATOR SIGNATURE: DATE: 11/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/26/2024
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 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: HUANG, XUECONG
FACILITY NUMBER: 434415687
VISIT DATE: 11/26/2024
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Licensee provides sleep cots for nap time. Children bring their own bedding. Licensee provides AM/PM snacks and lunch for the children. All beddings and food brought from children’s home are to be labeled with the children’s name and stored appropriately.

The outdoor play area is the backyard, which is completely fenced. The outdoor play area is free from defects or dangerous conditions. There is an ample supply of age-appropriate toys and activities available for children, and they are in good condition. There is ample shade available, and gates are locked at all times while children are in the backyard. There is a swing set that is properly anchored to the ground. The ground surrounding the swing set is padded with turf. Per licensee, there are no pools or similar bodies of water on premises. Licensee has one (1) small dog and two (2) rabbits in the backyard.

The licensee completed the Health and Safety training. The licensee’s Pediatric CPR/First Aid certification is current and expires on 06/15/2026. Licensee has completed the Mandated Reporter training for Child Care Providers and expires on 10/05/2025. The licensee is in compliance with the immunization laws. All adults living in the home have obtained a criminal record clearance.

LPA reviewed eight (8) children’s files and two (2) staff files. There is a current roster available for review, and a copy was obtained. The licensee owns the property. The facility has liability insurance and is current.

Licensee was reminded that California Law requires licensees to report unusual incidents or injuries to children in care, to child's parents, and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624B). Any structural changes to the home or additions to the childcare facility must be reported to Community Care Licensing. Incidents must be reported within 24 hours by phone, fax, or email. LPA informed the Licensee that all forms can be downloaded at www.ccld.ca.gov.

Licensee was also reminded that Mandated Reporter Training ("Child Care Providers") is required for all staff and is to be renewed every 2 years by visiting https://mandatedreporterca.com/. Licensee was reminded that EMSA approved Pediatric CPR & First Aid training must be completed every two (2) years.

Licensee was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.

Page 2 of 3. See LIC 809C.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Jialing Zhu
LICENSING EVALUATOR SIGNATURE:

DATE: 11/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/26/2024
LIC809 (FAS) - (06/04)
Page: 5 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: HUANG, XUECONG
FACILITY NUMBER: 434415687
VISIT DATE: 11/26/2024
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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.

Licensee was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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) or (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.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

No deficiencies cited during today's inspection. Three (3) Advisory Notes were issued:

· 1 assistant did not have proof of MMR (measles) immunization on file. (Technical Violation)

· 2 children’s immunization records were not up to date. (Technical Violation)

· LIC 700 forms were on file for all children, but some did not contain parent signatures. (Technical Assistance)

A Notice of Site Visit was given and must remain posted for 30 days. Exit interview was conducted, report was reviewed, and Appeal Rights were provided to licensee, Xuecong Huang. Page 3 of 3. End of Report.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Jialing Zhu
LICENSING EVALUATOR SIGNATURE:

DATE: 11/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/26/2024
LIC809 (FAS) - (06/04)
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