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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700089
Report Date: 02/18/2022
Date Signed: 02/18/2022 11:24:29 AM

Document Has Been Signed on 02/18/2022 11:24 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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:LIN, JOANNAFACILITY NUMBER:
015700089
ADMINISTRATOR:LIN, JOANNAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 713-9937
CITY:SAN LEANDROSTATE: CAZIP CODE:
94579
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 7DATE:
02/18/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:25 AM
MET WITH:Licensee, Joanna LinTIME COMPLETED:
11:40 AM
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Licensing Program Analyst ( LPA) Jyoti Saini met with Licensee, Joanna Lin for an unannounced Annual Inspection. LPA disclosed the purpose of the inspection and was granted entry into the facility by the licensee. Present during this inspection was Licensee and helper supervising 4 infants and 3 preschoolers. Licensee is within capacity limits of a Large License. The hours of operation are 8:00AM- 5:30PM, Monday -Friday.
ON LIMITS: The living room( daycare), kitchen( cooking food and walkway to go to the backyard only) the bedroom #1 to the immediate left when entering the home, and the bathroom #1 adjacent to the living room, storage closet in the hallway( to store diapers and wipes only) and half backyard.
OFF LIMITS: The dining room, bathroom #2 adjacent to the dining room, laundry room, bedroom#2 and bedroom #3 situated further down from the hallway leading to the garage, the garage, and half backyard.
LPA observed, Daycare Area is clean, orderly, and equipped with age appropriate toys and equipment for children. All off limit areas are made inaccessible by closed and/or locked doors and visual supervision. Home has a working telephone, a working smoke and carbon monoxide detector, and a fire extinguisher that meets the minimum requirements. There are no bodies of water or Fireplace in the Daycare area. There are child size tables and chairs for snack and activities.The napping room had cots in good condition and each child have their separate blankets. The blankets are washed weekly by the Parents. During inspection, Licensee requested to add half of the backyard into the day care area. LPA inspected the backyard for health and safety hazards. The Backyard is fenced, and it is free from defects or dangerous conditions. As of today, the half of the backyard is approved for ON-LIMIT use. Licensee states there are no guns or weapons of any kind in the home. Disaster drills are conducted at least once every six months, the last drill was conducted 10/20/2021

Licensee and helper’s CPR expire in 02/2023 and 01/2024 respectively. Licensee provides daily, 2 snacks and 3 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.

see next page...

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE: DATE: 02/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/18/2022
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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: LIN, JOANNA
FACILITY NUMBER: 015700089
VISIT DATE: 02/18/2022
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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.

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

Exit interview conducted and report was reviewed with the licensee Joanna Lin.

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

DATE: 02/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/18/2022
LIC809 (FAS) - (06/04)
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