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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700018
Report Date: 09/05/2024
Date Signed: 09/05/2024 02:52:58 PM

Document Has Been Signed on 09/05/2024 02:52 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:LU, HEFACILITY NUMBER:
015700018
ADMINISTRATOR/
DIRECTOR:		LU, HEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 317-1188
CITY:DUBLINSTATE: CAZIP CODE:
94568
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 11DATE:
09/05/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Licensee, He LuTIME VISIT/
INSPECTION COMPLETED:
03:10 PM
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Licensing Program Analyst (LPA) Jyoti Saini met with Licensee Lu He for an unannounced Annual Random Inspection. LPA disclosed the purpose of the inspection and was granted entry into the facility by the Licensee. During this inspection, the Licensee and helper were supervising three(3) infants and eight (8) preschoolers. The single-story home consists of 2 bedrooms, two bathrooms, a living room, a kitchen, a laundry room, a dining area, nook room, a backyard, and a garage. The hours of operation are 8:30 AM- 6:00 PM, Monday -Friday. The daycare area's entrance is through the facility's side gate. During the inspection, the licensee requested to add the nook room to the On- limit area. The Licensing Program Analyst (LPA) received an updated facility sketch and conducted a health and safety check of the nook room. The room was found to be free from defects and hazards. Effective today, 09/05/2024, the nook room is part of the daycare area.
On-limit areas: the living room ( main daycare area) and dining room, nook room, the bathroom to the left of the hallway, and the backyard.
Off-limit-areas are the Kitchen, Master bedroom, attached bathroom, Bedroom #2, laundry room, and garage. Off-limit areas are made inaccessible to children by closed and/or locked doors. 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 smoke and carbon monoxide detector, and a fire extinguisher meeting the minimum requirements. There is no fireplace in the house. There are child-size tables and chairs for snacks and activities. There are ample age-appropriate toys that appear safe and in good condition. Each child has their cot, blanket, and fitted sheet labeled with their name. In the backyard, there's a zikuzi, barricaded with white fence and fully covered, keeping it secure and inaccessible to the children in care.
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SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE: DATE: 09/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/05/2024
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: LU, HE
FACILITY NUMBER: 015700018
VISIT DATE: 09/05/2024
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The Licensee states there are no guns or weapons of any kind in the home. The Licensee has valid CPR and first aid on the file. The Licensee provides daily snacks and meals. Discipline policy is redirection. LPA reviewed children's files. All required postings are properly posted. LPA reviewed and obtained a copy of the roster. The Licensee conducts and documents fire and disaster drills. The log indicates that the last drill was conducted on 03/27/2024. The Licensee maintains a sleep log record. The Licensing Program Analyst (LPA) reviewed log during the inspection for the past two months.

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.

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

DATE: 09/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/05/2024
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: LU, HE
FACILITY NUMBER: 015700018
VISIT DATE: 09/05/2024
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 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; however, two (2) technical violation were given.



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

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

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

DATE: 09/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/05/2024
LIC809 (FAS) - (06/04)
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