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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434417396
Report Date: 01/29/2025
Date Signed: 01/29/2025 02:57:06 PM

Document Has Been Signed on 01/29/2025 02:57 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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:YANG, YANGFACILITY NUMBER:
434417396
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 4CENSUS: 4DATE:
01/29/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:45 AM
MET WITH:Yang Yang TIME VISIT/
INSPECTION COMPLETED:
03:15 PM
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Licensing Program Analyst (LPA) Martha Jimenez-Villanueva conducted an unannounced Annual Random Inspection and in response to Licensee's request to increase the capacity from 8 to 14 children. LPA met with Licensee, Yang Yang, and explained to her the nature of today's inspection. Also present in the home were licensee's adult helper, her mom and four (4) children: 3 infants & 1 toddlers. All required posting materials were posted. The daycare is open Monday thru Friday from 9:00 AM to 6:00 PM. Fire pull station is installed in the entry way near front door. Fire Clearance for large capacity was conducted and approved on January 15, 2025, by San Jose Fire Department. There are special conditions: Upstairs is off limits and gated.

LPA obtained a copy of current children's roster. Fire/disaster drill was conducted on August 15, 2024. LPA observed a fully charged 3A40BC fire extinguisher, functioning a combo smoke and carbon monoxide detector, gated kitchen, and gated stairs. Licensee states that there are no pets, no weapons, or firearms in the home. LPA observed no bodies of water or fireplace in the home. LPA discussed and provided licensee with the ratio and capacity chart.

Incidental Medical Services (IMS) policy was discussed. 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 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

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.

Report Continues in LIC 809-C page 2.
SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Martha Jimenez-Villanueva
LICENSING EVALUATOR SIGNATURE: DATE: 01/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/29/2025
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 3
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: YANG, YANG
FACILITY NUMBER: 434417396
VISIT DATE: 01/29/2025
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Report LIC 809C, page 2.

LPA toured the indoor and outdoor areas of the home with the applicant during today's inspection. Off limit areas inside the home: barricaded kitchen, two bedrooms, one bathroom, covered and gated shelf area, attached garage and entire second floor. The home has central heating, cooling, and ventilation for comfort of children. Off limit areas outside the home: Fenced front yard, fenced garden area and both sides of the home are barricaded. The backyard is barricaded. LPA observed a play structure for preschool age children in the backyard that is covered and do not used. The children area is barricaded.

LPA observed that the home is clean and orderly. Cleaning products, sharp objects, and other items that are dangerous to children were stored inaccessible. LPA observed sufficient age-appropriate materials, toys, and play equipment in the home. The children's bathroom is clean, sanitary, and operable.

LPA reviewed four (4) children's files during today's inspection for the following records: Notification of Parents Rights (LIC995A), Consent for Emergency Medical Treatment (LIC627), Identification and Emergency Information (LIC700), sleep log for children under 2 years old, and Immunization Records. Licensee carries daycare insurance with Heffernan Network Insurance Brokers-Walnut Creek and its current.
LPA reviewed a helper's file for the following records: Employee Rights (LIC 9052), Statement Acknowledging Requirement to Report Child Abuse (LIC 9108), immunization, TB test, and required training. Licensee has immunization in measles, pertussis, and flu. Licensee has current Pediatric CPR/First Aid certifications and expired in August 2025. Licensee's Mandated Reporter Training was completed on August 28, 2023. LPA reminded Licensee that Mandated Reporter Training must be renewed by all staff every 2 years.

LPA provided and discussed the safe sleep regulations with Licensee and discussed the Child Care Licensing Safe Sleep webpage at an additional resource. LPA also reminded Licensee of the importance of checking for recalled infant devices https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as 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.

Report Continues in 809-C page 3.
SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Martha Jimenez-Villanueva
LICENSING EVALUATOR SIGNATURE:

DATE: 01/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2025
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: YANG, YANG
FACILITY NUMBER: 434417396
VISIT DATE: 01/29/2025
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Report LIC 809C page 3.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

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

During the exit interview, the Licensee Yang Yang confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

No deficiencies were cited today.

A notice of site visit was given and must remain posted for 30 days.

Licensee Yang Yang was informed that a Large Family Child Care Home license would be approved pending on the following:
1) Approval from a manager of the Licensing Program.
SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Martha Jimenez-Villanueva
LICENSING EVALUATOR SIGNATURE:

DATE: 01/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2025
LIC809 (FAS) - (06/04)
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