<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434417896
Report Date: 08/08/2024
Date Signed: 08/08/2024 03:13:45 PM

Document Has Been Signed on 08/08/2024 03:13 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:ZHANG, HONGDANFACILITY NUMBER:
434417896
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
08/08/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:13 PM
MET WITH:Hongdan ZhangTIME VISIT/
INSPECTION COMPLETED:
03:35 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) Mandeep Kaur conducted an announced prelicensing inspection. LPA met with Applicant, Hongdan Zhang , and explained the reason for the inspection. Purpose of this inspection; Applicant applied for a small Family Child Care Home (FCCH) license. The Applicant and Applicant's husband are the only adults residing in the home. Applicant has two minor children including one child is under 10 year old, also residing in the home.

LPA reminded Applicant that child(ren) under 10 years old residing in the home, count as part of the
ratio.

The hours of operation will be Monday through Friday 8:30AM to 6:00PM. Applicant does not plan on
obtaining liability insurance for the day care. Applicant understands that parents will need to fill out
the Affidavit Regarding Liability Insurance (LIC 282) if she does not plan on obtaining liability insurance for the day care.

Applicant has a valid CPR/1st Aid, which expires on 03/30/2026. Applicant's Preventive Health and
Safety certificate and Mandated Reporter training certificate are on file. Applicant completed the Preventative health and Safety training on 05/24/2024 and Mandated Reporter training on 06/04/2024. LPA reminded Applicant that the Mandated Reporter training and CPR/1st Aid requires renewal every two years. Applicant's immunization records for TB, measles, pertussis, and declined statement for influenza are also on file.

**Continue on 809-C**
SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Mandeep Kaur
LICENSING EVALUATOR SIGNATURE: DATE: 08/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/08/2024
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 5
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: ZHANG, HONGDAN
FACILITY NUMBER: 434417896
VISIT DATE: 08/08/2024
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
**Continue from 809**

The applicant has not obtained a signed Property Owner/Landlord Consent form (LIC9149). Without this consent, the applicant understands that, once licensed, they can operate with a maximum capacity of 6 children. If property owner/landlord consent is obtained in the future, the applicant is advised that a new Application for a Family Child Care Home License (LIC 279) must be submitted with a change of capacity fee of $25, to increase the capacity and provide care to 8 children.

LPA toured the inside and outside of the home with Applicant. Applicant resides in a single story single family home. LPA observed the barricaded gate and locked doors to the off limit areas. Off limit areas include: 1 Master bedroom, 1 bedroom #2, Kitchen, attached Garage and 1 bathroom in master bedroom. LPA observed off limit areas outdoor: Gas water heater, air-conditioning unit, emergency gas shutoff, emergency panel shut off area is barricaded, and both sides of the home. Updated facility sketch (Floor Plan and Yard) with the labels was obtained during today's inspection
.
Applicant has play area for the children in the backyard of the home. LPA advised the applicant
that children need to be supervised at all times. The home is clean, orderly, including heating and
air conditioning, for safety & comfort. The Applicant has a valid phone in the home. There is sufficient toys, supplies, and equipment for the day care children indoors and outdoors.

LPA observed a fully charged fire extinguisher (2A10BC), working combo smoke & carbon monoxide detectors, no bodies of water, and fenced backyard. Applicant states that she does have a pet (turtle). Applicant states that a pet is always in the offlimit area: Garage. Applicant states that there are no weapons/ammunition in the home.

All disinfectants, cleaning supplies, and other items that could pose a risk to children were inaccessible. There were no baby walkers or bouncers observed in the on-limit areas for the children. Applicant understands that baby walkers or other similar items are not permitted for the children. LPA reminded Applicant that fire/disaster drill need to be conducted every six (6) months and documented.

**Continue on 809-C**
SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Mandeep Kaur
LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2024
LIC809 (FAS) - (06/04)
Page: 2 of 5
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: ZHANG, HONGDAN
FACILITY NUMBER: 434417896
VISIT DATE: 08/08/2024
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
**Continue from 809-C**

Forms of discipline to be used by Applicant: talk to the children and have them play with their favorite toy.
Applicant understands that children's personal rights should not be violated; including no corporal punishment. Isolation of sick children, supervision of children, capacity options, transportation of children, requirements for reporting suspected child abuse, unusual incidents/injuries, heat related illnesses, and requirements for assistant/substitute were also discussed.

Healthy Beverages requirements were discussed with the applicant.

LPA discussed the safe sleep regulations with Applicant 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 Applicant 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.

Applicant states that she will not administer medication once she has children in care. Applicant states that a
child will be isolated on the side of the living room #1 day care if necessary due to illness or communicable disease. Applicant has a First Aid kit with a touchless thermometer in the home.

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.

LPA reviewed with applicant the LIC 311D, Forms/Records to Keep In Your Family Child Care Homes,
children’s forms/records, facility forms/records, and information to be posted. Entrance Checklist was provided to the applicant.

**Continue on 809-C**
SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Mandeep Kaur
LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2024
LIC809 (FAS) - (06/04)
Page: 3 of 5
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: ZHANG, HONGDAN
FACILITY NUMBER: 434417896
VISIT DATE: 08/08/2024
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
** Continue from 809-C**

All adults have cleared criminal record clearance, child abuse index, and TB. Applicant 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.

On this date, 06/25/2024, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

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

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 athttps://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

**Continue on 809-C**
SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Mandeep Kaur
LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2024
LIC809 (FAS) - (06/04)
Page: 4 of 5
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: ZHANG, HONGDAN
FACILITY NUMBER: 434417896
VISIT DATE: 08/08/2024
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
** Continue from 809-C**

Exit interview conducted and report was reviewed with Applicant Hongdan Zhang. LPA advised Applicant that Small Family Child Care Home license will be issued with the capacity of maximum six (6) children upon completion of the following:

1. Licensing Program Manager (LPM) review and approval.
2. Screened fire place.
3. Lock to the heater door
SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Mandeep Kaur
LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2024
LIC809 (FAS) - (06/04)
Page: 5 of 5