<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700282
Report Date: 05/31/2023
Date Signed: 05/31/2023 11:50:21 AM

Document Has Been Signed on 05/31/2023 11:50 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:BAO, TINGFACILITY NUMBER:
015700282
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 3CENSUS: 3DATE:
05/31/2023
TYPE OF VISIT:Case Management - OtherANNOUNCEDTIME BEGAN:
10:55 AM
MET WITH:Ting BaoTIME COMPLETED:
11:50 AM
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 5/31/2023 at 10:55am Licensing Program Analyst (LPA) Morgan Pringle met with Licensee Ting Bao for an Announced Capacity Increase Inspection. Present during the inspection was the Licensee, her husband, S. Argilla and three (3) infants. Licensee lives in the home with her husband, and her twelve (12) year old daughter. Licensee’s home was toured for a health and safety inspection. The facility operates 8:30am – 5:30pm, Monday – Friday.

ON LIMITS AREA: Two (2) Downstairs Playrooms, Downstairs Bathroom, Downstairs Bedroom facing side of house, Right side of Backyard
OFF LIMITS AREA: Entire 2nd Floor, Kitchen, Living Room, Downstairs Bedroom that faces the street, Garage and remaining area of Backyard
ISOLATION AREA: Two (2) Downstairs Playrooms

This home was granted a fire clearance on 5/18/2023 from the Hayward Fire Department.

The facility is two story home owned by the applicant. The home consists of a Living Room, Kitchen, Dining Room, Playroom, Four (4) Bedrooms, Three (3) Bathrooms, Study, Library/TV Room, Garage and Backyard.

The inside of the home was observed to be neat, clean with ample age-appropriate materials for the children. All toxins, cleaning products, and hazardous materials were observed to be in inaccessible areas. Licensee provides all food for the children that is properly stored and maintained. All food that is brought from the children’s home will be properly labeled and stored. All cribs and napping equipment is clean, well maintained and free from defects. Licensee stated there are no firearms and no pets in the home. Licensee also will not transport children.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE: DATE: 05/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/31/2023
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 2
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: BAO, TING
FACILITY NUMBER: 015700282
VISIT DATE: 05/31/2023
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
26
27
28
29
30
31
32
The home has one (1) fully charged 2A10BC fire extinguisher in kitchen. There is one (1) working smoke detector in the downstairs bedroom and two (2) in the downstairs hallway. There is one (1) working carbon monoxide detector in the kitchen next to the refrigerator. The staircase is gated making the second floor inaccessible to the children in care. All off limit areas are made inaccessible by gates as well. The electric fireplace in the living room is not in use and gated. The backyard is fully fenced with ample materials for the children. The shed in the backyard is locked making it inaccessible to the children in care as well. The home is equipped with central heat and air for proper ventilation. LPA did not observe any harmful bodies of water in or around the home.

Licensee’s Health and Safety training with lead poisoning component has been completed. Licensees’ Pediatric CPR and First Aid training is completed and expires 6/5/2023. Licensee’s Mandated Reporter is complete and expires 7/17/2023. LPA obtained the fire/disaster drill log, log is complete with the last drill logged 12/9/2023. All adults living, working, and volunteering in the home have obtained a criminal record clearance. All required forms are posted and visible for public view on the wall by the front door of the home.

Licensee was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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.

This home has been recommended for a capacity increase for a large family childcare home on 5/31/2023.

Exit interview conducted and report was reviewed with the Licensee Ting Bao.

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:

DATE: 05/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2023
LIC809 (FAS) - (06/04)
Page: 2 of 2