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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013421741
Report Date: 06/30/2023
Date Signed: 06/30/2023 04:35:29 PM

Document Has Been Signed on 06/30/2023 04:35 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:LIN, YANGJINFACILITY NUMBER:
013421741
ADMINISTRATOR:LIN, YANGJINFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 308-6706
CITY:SAN LEANDROSTATE: CAZIP CODE:
94577
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 11DATE:
06/30/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Yanjin Lin, Jaincheng Feng, and Jinglin FengTIME COMPLETED:
04:45 PM
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Licensing Program Analyst (LPA) Andrew Elliot met with Licensee, Yangjin Lin for an unannounced Annual Random Inspection on 06/30/2023 at 2:15 PM. LPA disclosed the purpose of the inspection and was granted entry into the facility by the licensee. Present during this inspection was Licensee, and her husband supervising 4 infants and 7 preschoolers. The licensee is caring for children with the assistance of an aide, and is in ratio at the time of the inspection. Licensee lives in the house with her husband. The home is a one story house consisting of 3 bedrooms, 2 bathrooms, living room, dining room, kitchen, deck, and backyard. The hours of operation are 7:30am- 6:30pm, Monday -Friday.
ON LIMIT AREAS are bedroom#1, bedroom #2, the master bedroom and master bathroom, the living room, the hallway bathroom, kitchen, deck and back yard.
The OFF-LIMIT AREAS are the garage, and shed located in the backyard is made inaccessible by closed and/or locked doors and visual supervision.
LPA inspected the house for health and safety hazards. Daycare Area is clean, orderly, and equipped with age appropriate toys and equipment for children, indoors and outdoors. Home has a working telephone, a working smoke and carbon monoxide detector, and a fully charged model 3A-40-BC fire extinguisher that meets the minimum requirements. There are no bodies of water or Fireplace in the Daycare area. There are ample of age appropriate toys that appear to be safe and in good condition. LPA did not observe any hazardous materials or toxins accessible to children during today’s inspection. The napping room had playpens in good condition and each child have their separate blankets. Licensee states there are no guns or weapons of any kind in the home. There are no pets in the home. Licensee and her husband have valid CPR. Licensee provides daily snacks and meals. Discipline policy is redirection. LPA reviewed children’s files. All the files are complete and up to date. All required postings are properly posted. The licensee conducts and documents fire and disaster drills twice a year with the last was conducted on 05/25/2023. LPA reviewed a facility roster and obtained a copy. Licensee was reminded of the responsibility as a mandated reporter
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Andrew Elliott
LICENSING EVALUATOR SIGNATURE: DATE: 06/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/30/2023
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 4
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: LIN, YANGJIN
FACILITY NUMBER: 013421741
VISIT DATE: 06/30/2023
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 Licensee will complete the required mandated reporter training when it is offered in her primary language but is exempt from the mandated reporter training requirement at this time as it is not offered in the licensee’s preferred language Cantonese. LPA was able to review the required information for the licensee and her assistant, however the staffs’ employee information was not organized into staff files as per CCR 102416.1, nor did staff have signed copies of employee rights statements. Staff members’ dates of employment, date of birth, address, preventative health training information, and CPR training records were available for review by the LPA. Licensee was instructed that it is best practice to keep required employee information documented and organized in an staff file.
To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.
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. 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. This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514- 0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at:https://www.ada.gov/resources/child-care- centers/.
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.
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.
A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Lin Yangjin.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Andrew Elliott
LICENSING EVALUATOR SIGNATURE:

DATE: 06/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2023
LIC809 (FAS) - (06/04)
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