434416327-8-24-2021-07-CC-YHUG-C67TWZ-20210824150622

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434416327
Report Date: 08/24/2021
Date Signed: 08/24/2021 03:07:06 PM

Document Has Been Signed on 08/24/2021 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:	LUAN, LAN		FACILITY NUMBER:	434416327
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 0	CENSUS: 2	DATE:	08/24/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	01:45 PM
MET WITH:	Lan Luan		TIME COMPLETED:	03:25 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	Licensing Program Analyst (LPA) Oscar Huang met with Licensee Lan LUan for an unannounced case management inspection due to licensee's capacity increase request. LPA explained the nature of today’s inspection to Licensee. LPA also observed 2 daycare infants in the home during today's inspection. Days and hours of operation are Monday to Friday, 8:30 a.m. to 6:30 p.m. The adults that reside in the home are Licensee only. Licensee stated that her mother is taking care her school-age daughters in her mother's home during her operation hours. LPA advised her that they will be accounted for her capacity when present during her operation hours. 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 also reminded Licensee 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 violation within a 12-month period. Licensee understands upon notice of the Department to remove an individual from the home, or to exclude an individual from the home, Licensee shall immediately remove the individual and prevent them from returning to the home or having contact with children in care. LPA toured the indoor and outdoor areas of the home during today’s inspection. LPA observed that the home appears clean and orderly, with heating and ventilation for safety and comfort of the children. Licensee observed the temperature was 72 degree displayed on the thermometer, LPA advised her to keep temperature within 68-85 degrees. LPA observed no baby walker, bouncers, excer-saucers, jumpers etc. on the premises. LPA observed no stairs inside the home. The main area of the home is used for the day care are living room, dinning room, bedroom # 1& #2 and bathroom #1. LPA observed no fireplace. LPA observed safe and sufficient materials, toys, and play equipment for the day care children. All sharp objects, detergents, cleaning compounds, medications, poisons, and other similar items are stored in top cabinets in the kitchen inaccessible to children. LPA observed a fully charged 3A40BC fire extinguisher, at least one working combined smoke/carbon monoxide detector. Licensee states there are no weapons/firearms and pets in the home. Off limit areas indoor: master bedroom, master bathroom, kitchen, and garage. LPA observed a fenced backyard and no bodies of water. Off limit areas outside the home: two gated side yards. Licensee rents the house, and carries child care liability insurance under DCI. LPA observed Licensee has current CPR and First Aid certifications expiring 1/2022. LPA observed a current roster of the children. LPA reviewed all 3 infants files mandated by the regulation including immunization records are maintained and up-to-date, Parent's Rights. Facility Evaluation Report dated 08/24/2021 to be continued on next page:

SUPERVISORS NAME: Sandy Knight
LICENSING EVALUATOR NAME: Yangcheng Huang
LICENSING EVALUATOR SIGNATURE:	DATE: 08/24/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2021

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: LUAN, LAN	FACILITY NUMBER: 434416327
	VISIT DATE: 08/24/2021

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
26
27
28
29
30
31
32

Facility Evaluation Report dated 08/24/2021 to be continued from previous page:
Supervision of children was discussed with Licensee, and she understands that she must be present in the home during day care hours and ensure that the children are supervised at all times. Licensee understands her capacity options. 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 reviewed safe sleep policies for the infants with the Licensee and provided Licensee "A Child Care Provider's Guide to Safe Sleep” document as well as the most recent PIN 20-24-CCP for Infant SafeSleep and the requirement for checking and logging during the nap in every 15 minutes, including LIC 9227 for infants under one year old. More information can be founded at http://www.cdss.ca.gov/inforesources/Child-Care-Licensing. LPA observed all LIC 9227 were filled and signed by the parents and nap records for all the infants.

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 child above 2 years old shall be taught to wear masks.

LPA discussed SB 792 Immunization Requirement with Licensee. LPA observed appropriate records for immunizations against measles, pertussis, and influenza for her in file. Incidental Medical Services (IMS) were discussed with Licensee. Licensee is not providing IMS at this time. 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: http://www.ada.gov/childqanda.htmLicensee will submit a plan of operation for IMS if in the future they provide any IMS to a child in care.

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: https://mandatedreporterca.com/ . Licensee has completed her training on 03/08/2020, and the certification is on file.

A fire clearance granted from the Sunnyvale Fire Department was received on 08/18/2021 and was on file: The entire home and outdoor space were inspected. Master bedroom & bathroom are off limits.

LPA conducted exit interview with Licensee and advised her that a large Family Child Care Home license is now pending upon the management approval.

SUPERVISORS NAME: Sandy Knight
LICENSING EVALUATOR NAME: Yangcheng Huang
LICENSING EVALUATOR SIGNATURE:	DATE: 08/24/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2021

LIC809 (FAS) - (06/04)

Page: 2 of 2