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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013419189
Report Date: 04/14/2022
Date Signed: 04/14/2022 03:29:21 PM

Document Has Been Signed on 04/14/2022 03:29 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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:ZHU, HUIFENGFACILITY NUMBER:
013419189
ADMINISTRATOR:ZHU, HUIFENGFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 429-1669
CITY:FREMONTSTATE: CAZIP CODE:
94555
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 11DATE:
04/14/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Huifeng ZhuTIME COMPLETED:
03:50 PM
NARRATIVE
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On April 14th, , 2022 @ 1:00PM, Licensing Program Analysts (LPAs) April Wright and Jyoti Saini arrived for an unannounced Annual/Random Inspection and met with Licensee Huifeng Zhu. Present for this inspection were 5 infants, 6 preschool age children, a volunteer Huilien Chu, and the licensee's fingerprint cleared husband.. The home was toured with the licensee to conduct a health and safety inspection. Hours of operation for day care are Monday through Friday, 8:00am to 6:00pm.

The home is two story, which is neat and clean, with heating and ventilation for safety and comfort. The stairway to second floor had a child safety gate in place. The outdoor play area is fenced and is free from defects and dangerous conditions. There were ample age appropriate toys, inside and outside, that were observed to be safe and in good condition. Toxins, medicines, and hazardous items were inaccessible during today's inspection.

ON LIMIT Areas: Entire first floor and the backyard.
OFF LIMITS Areas: Second floor and the garage, which are inaccessible by closed and/or locked doors and visual supervision. The home has a fully charged 2 A10 BC fire extinguisher, working carbon monoxide and smoke detectors, telephone, and first aid kit.

Records Review: LPA Wright requested and reviewed the files of four 11 children in care as well as facility files. All children's files contained Immunization, Parent's Rights, and Medical Consent forms. The facility roster was reviewed, and copies were obtained. The licensee conducts and documents fire and disaster drills twice a year with the last one conducted on 2/15/2022. The licensee's Health and Safety training is completed, and CPR and First Aid certificate is current and expires 5/2023. The licensee has completed mandated reporter training on 09/20/2022. The licensee is was out of ratio today and all required forms are posted and visible for public review.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: April Wright
LICENSING EVALUATOR SIGNATURE: DATE: 04/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/14/2022
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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: ZHU, HUIFENG
FACILITY NUMBER: 013419189
VISIT DATE: 04/14/2022
NARRATIVE
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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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/childqanda.htm

California Law requires Child Care Centers 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 by phone, fax, or electronic mail. Roster of the children must be properly maintained, and fire/disaster drill every six months must be documented.

The licensee is reminded any structural changes to the home or additions to the childcare facility must be reported to Community Care Licensing. The licensee was provided information regarding effects of Lead Exposure and testing requirements (Assembly Bill 2370)

LPA discussed the Safe sleep regulations with licensee and discussed Child Care Licensing Safe Sleep webpage https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee 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

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: April Wright
LICENSING EVALUATOR SIGNATURE:

DATE: 04/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2022
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 04/14/2022 03:29 PM - It Cannot Be Edited


Created By: April Wright On 04/14/2022 at 02:27 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: ZHU, HUIFENG
FACILITY NUMBER: 013419189

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/14/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102416.5(d)
Staffing Ratio and Capacity
(d) For a Large Family Child Care Home, the maximum number of children for whom care may be provided at any one time when there is an assistant provider in the home, including children under age 10 who reside at the licensee's home and the assistant provider's children under age 10, shall be either:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, record review, the licensee did not comply with the section cited above. LPAs observed that at 1:15pm the facility has 5 infants and 6 preschoolers present in the home simultaneously, placing the facility out of ratio. This poses an immediate health, safety or personal rights risk to children in care.
POC Due Date: 04/15/2022
Plan of Correction
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Licensee shall submit a plan of correction to demonstrate how she is going to maintain the day-care within ratio and capacity by 4/15/2022, LPAs discussed ratio requirements for a large family child care home with licensee.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Wynn Norona
LICENSING EVALUATOR NAME:April Wright
LICENSING EVALUATOR SIGNATURE:
DATE: 04/14/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/14/2022


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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: ZHU, HUIFENG
FACILITY NUMBER: 013419189
VISIT DATE: 04/14/2022
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The following deficiencies were observed during today's inspection:
  • At 1:15pm, LPAs observed 5 infants and 6 preschoolers - provider was out of ratio

Type A deficiency is cited today( Please see attached LIC809-D)

LICENSEE MUST POST ANY TYPE A DEFICIENCIES DURING TODAYS VISIT WITH THE NOTICE AND LICENSEE UNDERSTANDS THE NOTICE AND TYPE A DEFICIENCIES MUST REMAIN POSTED FOR THIRTY DAYS. REQUIREMENTS FOR AB 633 FACT SHEET AND A COPY OF ACKNOWLEDGEMENT OF RECEIPT OF LICENSING REPORTS (LIC 9224) WERE DISCUSSED WITH PROVIDER. PROVIDER UNDERSTANDS THIS REQUIREMENT.

The licensee also received technical violations for Safe Sleep practices and 2 Technical advisories for Infant Sleep plan and No Employee file present.

Licensee was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a childcare center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated. All forms can be downloaded at www.ccld.ca.gov



A notice of site visit was given and must remain posted 30 days. Exit interview conducted and report was review with licensee Huifeng Zhu.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: April Wright
LICENSING EVALUATOR SIGNATURE:

DATE: 04/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2022
LIC809 (FAS) - (06/04)
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