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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013417809
Report Date: 10/09/2024
Date Signed: 10/09/2024 12:33:51 PM

Document Has Been Signed on 10/09/2024 12:33 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:LIU, YINGNIANFACILITY NUMBER:
013417809
ADMINISTRATOR/
DIRECTOR:		LIU, YINGNIANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 461-1776
CITY:PLEASANTONSTATE: CAZIP CODE:
94566
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
10/09/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:15 AM
MET WITH:Yiingnian LiuTIME VISIT/
INSPECTION COMPLETED:
12:55 PM
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On October 9, 2024, Licensing Program Analysts (LPAs) Lorraine Dacanay Breaux met with licensee Yingnian Liu for an Unannounced Required 1 Year Inspection. LPA disclosed the purpose of the inspection and was granted entry into the facility by the licensee. There were no children present during the inspection. Licensee stated that the facility operates Monday to Friday 11:30 AM - 6:30PM.

This is a two story home with 5 bedrooms and 4 bathrooms. LPA toured the facility inside and outside to conduct a Health and Safety inspection. This home was clean and orderly, with heating and ventilation for the safety and comfort. The Isolation area of the home will be a section of the family room, away from other children in care.

On-limit-areas: Living and dining room, family room, kitchen, bathroom on the main floor, hallway, one bedroom on the main floor next to the bathroom and backyard.

Off-limit-areas: The entire second floor, which includes all bedrooms up stairs (4 bedrooms and 3 bathrooms), entire second level of home, laundry room, right and left side-yard and two car garage.

The off-limits area will be made inaccessible by closed and/or locked doors and visual supervision. LPA did not observe any hazardous materials or toxins accessible to children during today’s inspection. There are no pools, hot tubs or any other bodies of water present in the on-limit areas during today's inspection. Licensee confirmed there are no pools/hot tubs and/or bodies of water at the home.

The home has a working smoke detector, working carbon monoxide detector, first aid kit, telephone, and fully charged 3A40BC fire extinguisher located in the kitchen. Per licensee, there are no firearms in the home. Licensee confirmed she lives in the home. The licensee is in compliance with the immunization laws which pertains to all childcare providers. Per licensee she does transport children usually walks when the weather permits.

See 809-C

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux
LICENSING EVALUATOR SIGNATURE: DATE: 10/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/09/2024
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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: LIU, YINGNIAN
FACILITY NUMBER: 013417809
VISIT DATE: 10/09/2024
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The licensee completed the Health and Safety training, CPR/First Aid certification expires on 01/27/2026. The licensee is in compliance with the immunization laws and has completed the mandated reporter training on 02/10/2023. Licensee is reminded of their responsibility to renew CPR/First Aid and Mandated Reporter certificates every two years. The licensee has not conducted and documented fire/disaster drills due to no enrollment in over 6 months. LPA reminded licensee to conduct fire/disaster drill when the children enroll. All required forms are posted and visible for public review.

Records: At 11:10 AM, LPA requested personnel records and reviewed. for review.



CCLD Inspection Process: 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.

Criminal Record Clearance: Licensee was reminded that all adults 18 and over living or working in the home, 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.

MyChildCarePlan.org: 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&Rs) throughout California.

LIC 809-C

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux
LICENSING EVALUATOR SIGNATURE:

DATE: 10/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2024
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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: LIU, YINGNIAN
FACILITY NUMBER: 013417809
VISIT DATE: 10/09/2024
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Per licensee does not provide care for children under 4 years old. Per licensee does not administer medication.

Incidental Medical Services (IMS): Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes 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)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at http://www.ada.gov/resources/child-care-centers/.

Megan’s Law: During the exit interview, the licensee, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

Unusual Incident/Student Injury Report: Effective August 1, 2003 California Law requires Child Care Licensees to report unusual incidents or injuries to children in care to child’s parents and to the Department of Social Services using the Unusual Incident/Injury Form (LIC 624). Incidents must be reported within 24 hours to the regional office by phone and the written report, LIC 624, within 7 business days.

No deficiencies found during today's inspections.

A notice of site visit was given and must remain posted for 30 days. Appeal Rights provided. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. Exit interview conducted and report was reviewed with the licensee, Yingnian Liu.

End of Report

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux
LICENSING EVALUATOR SIGNATURE:

DATE: 10/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2024
LIC809 (FAS) - (06/04)
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