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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423029
Report Date: 03/07/2024
Date Signed: 03/07/2024 10:32:58 AM

Document Has Been Signed on 03/07/2024 10:32 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:HU, XIUFANGFACILITY NUMBER:
013423029
ADMINISTRATOR:HU, XIUFANGFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 206-9096
CITY:CASTRO VALLEYSTATE: CAZIP CODE:
94546
CAPACITY: 14TOTAL ENROLLED CHILDREN: 12CENSUS: 12DATE:
03/07/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
08:34 AM
MET WITH:Xiufang Hu- LicenseeTIME COMPLETED:
10:45 AM
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On 3/7/24, Licensing Program Analyst Briana Plumboy met with licensee Xiufang Hu for an UNANNOUNCED ANNUAL REQUIRED INSPECTION. Present for this visit was 3 infants, 9 preschool age children, fingerprint clear and associated assistant Y.Guan, and licensee's fingerprint clear and associated husband G.Chen. The home was toured to conduct a Health and Safety Inspection. The facility currently operates Monday through Friday from 7:30am until 6:00pm.
The home is single story. The home consists of 8 rooms. The home is neat with heating and ventilation for safety and comfort. The OFF LIMIT AREAS are the bedroom located against the back wall on the right, the first bedroom on the right side of the hallway, the laundry room and bathroom located off the kitchen, and the back half of the backyard which will be inaccessible by closed and/or locked doors and visual supervision. The ON LIMIT AREAS are the living room, the bedroom located against the back wall on the left, the hallway bathroom, the kitchen/dining room combo, and the front half of the backyard. The ISOLATION AREA will be the first room located on the right side of the hallway. Outdoor play area will be in the first half of the fenced backyard. There is a garage/storage unit located inside the backyard which is off limits to children in care. There are toys and learning activities available during today's inspection.
There is a 2A10BC fire extinguisher, carbon monoxide detector, pull down fire alarm, and working smoke detector during today's inspection.
There are no pets in the home. All required licensing documents are posted and visible for public review. The licensee's Pediatric CPR/First Aid certificate is current and expires 07/23/24 and licensee's assistant Y.Guan is current and expires 2/24/26. Licensee's mandated reporter training was completed on 01/03/23, her husband G.Chen completed his training on 3/11/23, and the assistant present is aware once the training is available in her native language she must complete the training. License, her husband, and her assistant Y.Guan are compliance with the immunization law. The licensee is documenting sleep checks. The licensee possesses current day care insurance and provided LPA with a copy of her policy. Per licensee, there are no firearms in the home. The licensee documents fire and disaster drills.
Licensee provided a copy of the Lic. 9040 to LPA and it was reviewed for completeness. The licensee is in ratio today. All REQUIRED forms are posted and visible for public review. See 809-C for continuance
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Briana Plumboy
LICENSING EVALUATOR SIGNATURE: DATE: 03/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/07/2024
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: HU, XIUFANG
FACILITY NUMBER: 013423029
VISIT DATE: 03/07/2024
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Licensee Xiufang Hu 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 Xiufang Hu 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: 03/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2024
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: HU, XIUFANG
FACILITY NUMBER: 013423029
VISIT DATE: 03/07/2024
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Licensee Xiufang Hu 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 Xiufang Hu 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 Xiufang Hu 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 Xiufang Hu 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 Xiufang Hu.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Briana Plumboy
LICENSING EVALUATOR SIGNATURE:

DATE: 03/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2024
LIC809 (FAS) - (06/04)
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