013421948-5-14-2024-52-CC-BPLY-D59TVQ-20240514150418

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013421948
Report Date: 05/14/2024
Date Signed: 05/14/2024 03:04:24 PM

Document Has Been Signed on 05/14/2024 03:04 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:	MA, JING		FACILITY NUMBER:	013421948
ADMINISTRATOR/ DIRECTOR:	MA, JING		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 368-3911
CITY:	CASTRO VALLEY	STATE: CA	ZIP CODE:	94546
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 12	CENSUS: 12	DATE:	05/14/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:20 PM
MET WITH:	Jing Ma- Licensee		TIME VISIT/ INSPECTION COMPLETED:	03:20 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 5/14/24, Licensing Program Analyst Briana Plumboy met with licensee Jing Ma for an UNANNOUNCED RANDOM INSPECTION. Present for this visit was 12 preschool age children, and licensee's fingerprint clear and associated assistants Meiqi Huang and Shao Ping. The home was toured to conduct a Health and Safety Inspection. This facility currently operates Monday through Friday from 8:00am until 6:00pm. The home is a two story home. The home is neat and clean with heating and ventilation for safety and comfort. The ON LIMIT AREAS are the living room which is converted into a classroom, kitchen, dining room, family room which has been converted into a playroom, the bathroom which is located 3 stairs down from the family room and has a barricade to prevent access to the stairs, and the deck in the yard. The OFF LIMIT AREAS are the entire second level of the home and the garage which will be inaccessible by closed and/or locked doors and visual supervision. The ISOLATION AREAS are corners in the living room and family room. The stairs which lead to the second level of the home have a gate barricade located at the bottom, and there are barricades located throughout the on limit areas at the entrances and exits. The BACKYARD play area is fenced. The children only play on the deck in the yard and there is a gate on the stairs which lead to the entrance of the deck. There are learning materials and toys that appear to be safe and in good condition. There are no pools, hot tubs or any other bodies of water present during today's inspection. All hazardous materials and toxins are kept out of the reach of children and it was observed that there are no toxins or hazardous items accessible during today's inspection. The home has a fully charged 2A10BC fire extinguisher, working smoke detector, working carbon monoxide detector, and working telephone. The licensees CPR and First Aid certificate is current and expires 03/25/2025. The licensee Ms. Jing Ma and the assistants present today are in compliance with the provider immunization law. Licensee Jing Ma and her assistants currently have waivers for the mandated reporter training certificate until it is available in Mandarin. Licensee is aware once the mandated reporter training is available in (See 809-C for continuance)

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Briana Plumboy
LICENSING EVALUATOR SIGNATURE:	DATE: 05/14/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2024

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: MA, JING	FACILITY NUMBER: 013421948
	VISIT DATE: 05/14/2024

NARRATIVE

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Mandarin, herself and assistants must complete the training and receive certificates of completion. This facility has current Daycare insurance. The licensee conducts and documents fire/disaster drills with the last one conducted on 03/18/24. The licensee is in ratio today. All REQUIRED forms are posted and visible for public review.

Licensee Jing Ma is aware she should have knowledge of all Title 22 Regulations and follow all Title 22 Regulations at all times, as well as follow manufacture guidelines for all equipment in the facility.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02CCP. When any IMS is provided, a Plan for Providing 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: https://www.ada.gov/resources/child-care-centers/.

Licensee was encouraged to frequently visit our website at ccld.ca.gov for licensing regulations and updates.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms.

To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-carelicensing/subscribe and select the Child Care option to receive email communication.

Licensee Jing Ma 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.

See 809-C for continuance

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Briana Plumboy
LICENSING EVALUATOR SIGNATURE:	DATE: 05/14/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2024

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: MA, JING	FACILITY NUMBER: 013421948
	VISIT DATE: 05/14/2024

NARRATIVE

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Licensee Jing Ma 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.

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

During the exit interview, the Licensee Jing Ma confirmed that there are no Registered Sex Offenders living in the facility.

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

No deficiencies today's inspection. Appeal rights provided and discussed. Exit interview conducted and report was reviewed with licensee Jing Ma.

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Briana Plumboy
LICENSING EVALUATOR SIGNATURE:	DATE: 05/14/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2024

LIC809 (FAS) - (06/04)

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