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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013420318
Report Date: 08/12/2022
Date Signed: 08/12/2022 11:38:20 AM

Document Has Been Signed on 08/12/2022 11:38 AM - 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:ZHANG, JUNFACILITY NUMBER:
013420318
ADMINISTRATOR:ZHANG, JUNFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 676-8125
CITY:FREMONTSTATE: CAZIP CODE:
94539
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 10DATE:
08/12/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
11:05 AM
MET WITH:Jun ZhangTIME COMPLETED:
11:45 AM
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On today's date, 8/12/2022 at 11:05AM Licensing Program Analyst (LPA) Melanie Otsuji arrived to the facility unannounced to conduct a Plan of Correction (POC) visit. Present during today's visit was the Licensee, Jun Zhang, a fingerprint cleared assistant and 10 children (9 preschoolers, 1 infant).

The following corrections have been made:

1) 102416.5(d)(2) Licensee is now within the appropriate ratio.

There are no deficiencies cited today. Copy of Cleared POC's letter provided.

An exit interview was conducted. This report must be available for review for 3 years. A notice of site visit was posted. Notice of site visit must remain posted for 30 days.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Melanie Otsuji
LICENSING EVALUATOR SIGNATURE: DATE: 08/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/12/2022
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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