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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 435700379
Report Date: 10/19/2023
Date Signed: 10/19/2023 01:18:50 PM

Document Has Been Signed on 10/19/2023 01:18 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 EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:FAN, SITINGFACILITY NUMBER:
435700379
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 4CENSUS: 3DATE:
10/19/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Siting "Gracie" FanTIME COMPLETED:
01:15 PM
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On 10/19/2023 at 11:30am, Licensing Program Analyst (LPA) Christina Uribe conducted an unannounced Case Management visit for the purpose of a capacity increase. LPA Uribe met with licensee, Siting "Gracie" Fan, and also present at the time of the inspection was 3 day care children.

Application for Capacity Increase: All documents have been received for the increase of capacity application. The fire clearance for a capacity of 10 children was received from the Mountain View Fire Department on 07/23/2023. The licensee was reminded to abide by the conditions of the fire clearance which restricts the use of the garage to children in care. The licensee was reminded that an assistant must be present at all times when there is more than 8 children in attendance. Whenever the assistant is not present, the licensee will comply with the capacity requirements for a small family child care home. Please note that the fire clearance inspection request was for the capacity of 14 children, however, Inspector Imobersteg of the Mountain View Fire Department only approved a capacity of 10 children due to the square footage of the on-limit and usable areas of the home. Licensee understands that she is restricted to have only 10 children in care at any time. If the licensee would have more than 10 children in care at one time, this will be subject to a citation for being over capacity.

During today's visit, Licensee also asked multiple licensing related questions and these were discussed with LPA Uribe for consultation.

The home is recommended for an increase of capacity and will go effective today, 10/19/2023.

A notice of site visit of given was given and must be posted for 30 days. Exit interview was conducted and report was reviewed with the licensee, Siting "Gracie" Fan.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Christina Uribe
LICENSING EVALUATOR SIGNATURE: DATE: 10/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/19/2023
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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