434417332-8-9-2024-07-CC-ACOZ-D7YNUB-20240809104603

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434417332
Report Date: 08/09/2024
Date Signed: 08/09/2024 10:46:13 AM

Document Has Been Signed on 08/09/2024 10:46 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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	FU, RUFANG		FACILITY NUMBER:	434417332
ADMINISTRATOR/ DIRECTOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 5	DATE:	08/09/2024
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:05 AM
MET WITH:	Rufang Fu		TIME VISIT/ INSPECTION COMPLETED:	10:55 AM

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On 8/9/24 at 9:05AM Licensing Program Analyst (LPA) Andrea Cortez and Licensing Program Manager (LPM) Gladys Kuizon conducted an unannounced case management inspection for capacity increase for large (14) home child care. LPA met with Licensee Rufang Fu. LPA interviewed Licensee, obtained children's roster, and toured facility.

Upon arrival LPA observed 5 children (C1-C5) playing in the living and 2 staff (S1-S2)

LPA toured the indoor and outdoor areas of the home during today's visit. LPA reviewed the Child Care Facility Roster and Fire/Disaster drill log during today's visit. LPA reminded the Licensee that she needs to keep her roster updated with all current and former day care children. LPA reviewed five children's files and observed immunization records and the Family Child Care Home Notification of Parents' Rights forms (LIC 995A) in each file. The Licensee has a working telephone in the home. LPA observed sufficient materials, toys, and play equipment for the day care children. The home is orderly, and hazard free for day care children. LPA did not observe any wall heaters inside the home. Off limit areas in the home: Off limit areas: Garage, master bedroom master bath, bedroom 2.

LPA observed a fully charged 3A40BC fire extinguisher, working smoke & carbon monoxide detectors, fenced backyard, and no bodies of water. The Licensee states that she does not have any weapons in the home. All poisons are inaccessible to children.
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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Andrea Cortez
LICENSING EVALUATOR SIGNATURE:	DATE: 08/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2024

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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: FU, RUFANG	FACILITY NUMBER: 434417332
	VISIT DATE: 08/09/2024

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Incidental Medical Services (IMS) policy was discussed. Applicant currently does not offer. When any IMS is provided, an updated Plan of Operation that includes IMS and 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.htm

A review of guardian records 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 applicant 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.

Supervision of children was discussed with the Licensee. Licensee understands that she must be present in the home at least 80 percent of the hours the day care is in operation and ensure that the children are always supervised. The Applicant understands her capacity ratios. The Applicant states that she does transport children. LPM gave capacity ratio chart for large family home child care for reference.

Applicant understands that the application for a large childcare license is to be reviewed by Management prior to licensing approval.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Andrea Cortez
LICENSING EVALUATOR SIGNATURE:	DATE: 08/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2024

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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: FU, RUFANG	FACILITY NUMBER: 434417332
	VISIT DATE: 08/09/2024

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LPA reminded Licensee upon issuance of Type A citations, a copy of the Facility Evaluation Report LIC809 has to be posted on the wall and a copy to be given to all parents of currently and newly enrolled children for next 12 months. In addition, copy of LIC9224 Statement Acknowledging Receipt of Licensing Reports need to be signed and kept in child files.

Upon the issuance of Type A citations, a copy of the Facility Evaluation Report LIC809 has to be posted on the wall and a copy to be given to all parents of currently and newly enrolled children for next 12 months. In addition, copy of LIC9224 Statement Acknowledging Receipt of Licensing Reports need to be signed and kept in child files.

No deficiency cited.

An exit interview was conducted. A copy of this report was discussed and left with the Licensee, whose signature on this form confirm receipt of these documents.

A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE ENTRANCE TO THE FACILITY, AND MUST REMAIN POSTED FOR 30 DAYS.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Andrea Cortez
LICENSING EVALUATOR SIGNATURE:	DATE: 08/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2024

LIC809 (FAS) - (06/04)

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