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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013421214
Report Date: 01/14/2025
Date Signed: 01/14/2025 02:41:09 PM

Document Has Been Signed on 01/14/2025 02:41 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:HE, FENGFACILITY NUMBER:
013421214
ADMINISTRATOR/
DIRECTOR:		HE, FENGFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 334-1337
CITY:DUBLINSTATE: CAZIP CODE:
94568
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 12DATE:
01/14/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Licensee, He, fengTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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Licensing Program Analyst (LPA) Jyoti Saini met with Licensee He Feng for an unannounced Annual Random Inspection. LPA disclosed the purpose of the inspection and was granted entry into the facility by the Licensee. Present during this inspection were the Licensee and two helpers supervising four (4) infants and eight (8) preschoolers. The Licensee's primary language is not English. The Licensee's daughter, Yanxia Ma, arrived during the inspection and helped translate. The home is a single-story house with four bedrooms, two bathrooms, a living room, a kitchen, a dining area, a backyard, and a garage. The hours of operation are 8:00 AM- 6:00 PM, Monday -Friday. The facility has liability insurance through Accord Insurance.
ON LIMIT AREAS: the living room (playroom), bedroom #1, located on the right side of the hallway, the dining room, the bathroom located at the end of the hallway, and the backyard. OFF-LIMIT AREAS are the master bedroom/bathroom, two bedrooms in the hallway, kitchen, sides of the backyard, and garage.
LPA inspected the house for health and safety hazards. The daycare Area is clean, orderly, and equipped with age-appropriate toys. The home has a working telephone, a working smoke and carbon monoxide detector, and a fire extinguisher that meets the minimum requirements. During today's inspection, LPA did not observe any bodies of water. The Licensee conducts documents Fire/Disaster Drills and the log indicates that a last drill was conducted on 01/11/2024. There are child-size tables and chairs for snacks and activities. During the inspection, LPA observed that all the children had separate cots, blankets, and sheets. The Licensee stated that the parents wash the sheets and blankets weekly. The Licensee states there are no guns or weapons of any kind in the home. There are no pets in the house. The outdoor play area is fenced and safe, with rubber mats for cushioning. The backyard features a two-play structure and two plastic picnic tables. The Licensee and helpers have valid CPR and first aid certification on the file. Licenses and helpers have current mandated reporter certificates on the file. The Licensee provides daily snacks and meals. LPA reviewed children's files. All the files are complete and up to date. All required postings are properly posted. The licensee checks and documents the infant's sleep checks. LPA reviewed the 15-minute sleep log during the inspection. A copy of the facility roster was reviewed and obtained.
see next page..
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE: DATE: 01/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/14/2025
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: HE, FENG
FACILITY NUMBER: 013421214
VISIT DATE: 01/14/2025
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During Inspection, Licensee was reminded that all adults 18 and over living or working in the home, 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 licensed Family Child Care Home. 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.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at 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.



Licensee was reminded about Mandated Reporter training available on CCLD website. Training must be completed every 2 years. Training can be taken online at www.mandatedreporterca.com

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/inspection-process.

No deficiency is cited today.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee, He, Feng.

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE:

DATE: 01/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2025
LIC809 (FAS) - (06/04)
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