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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 496802021
Report Date: 03/20/2025
Date Signed: 03/20/2025 03:21:27 PM

Document Has Been Signed on 03/20/2025 03:21 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, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:B&J CHARNING CROSSFACILITY NUMBER:
496802021
ADMINISTRATOR/
DIRECTOR:
XIANGZHONG, FANFACILITY TYPE:
735
ADDRESS:1008 CHARNING CROSS LANETELEPHONE:
(707) 791-7371
CITY:SANTA ROSASTATE: CAZIP CODE:
95401
CAPACITY: 6CENSUS: 3DATE:
03/20/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:50 PM
MET WITH:Fan "John" Xiangzhong (Administrator)TIME VISIT/
INSPECTION COMPLETED:
03:36 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) Cuadra arrived unannounced to conduct an Annual Required inspection and met with Administrator, Fan "John" Xiangzhong. Clients were attending to day program during visit. The facility is in the process of change of ownership. Annual fees are current. Required postings were observed.

LPA/Administrator initiated a tour of the facility at 2:20 pm and observed the following. Facility was a comfortable temperature and passageways were free from obstructions, but there was some debris and items that needs to be cleared from the backyard, items were not obstructing any exits, but needs to de discarded (technical violation issued). Client rooms are furnished per regulation. The facility doesn't have an evacuation chair (technical violation issued). Extra linens and hygiene products are available. Water temperature in client bathrooms read at 112.6 which are within regulation of 105 and 120 degrees F. At least two days of perishable and one week of non-perishable foods were available. Additional perishable and non-perishable food is stored in the garage. Toxins were inspected and are stored in a locked cabinet in the garage. Fire extinguishers were last inspected December 2024. Facility has a fire pull system. Smoke detectors and carbon monoxide detector located throughout the facility were tested and operational. Last disaster drill was conducted on March 5, 2025. Medication and their records were reviewed.

File review initiated at 2:45pm. Three client files and three staff files were reviewed. All staff have current CPR/1st aid on file and required training hours completed. Administrator certificate for administrator Fan Xiangzhong #7012046735 expires on 6/6/2026. Cash resources reviewed.

Administrator agrees to submit updates of the following documents by 3/28/25: Personnel Report (LIC500), Designation of Administrative Responsibility (LIC308), Surety Bond and Control of Property (Deed).

No deficiencies cited during today's inspection. Exit interview conducted with Administrator and copy of this report was given.
SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Marisol Cuadra
LICENSING EVALUATOR SIGNATURE: DATE: 03/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/20/2025
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