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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700348
Report Date: 02/15/2023
Date Signed: 02/15/2023 11:04:48 AM

Document Has Been Signed on 02/15/2023 11:04 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:DENG, SUHONGFACILITY NUMBER:
015700348
ADMINISTRATOR:DENG, SUHONGFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 728-1896
CITY:CASTRO VALLEYSTATE: CAZIP CODE:
94546
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 8DATE:
02/15/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:04 AM
MET WITH:Suhong Deng- LicenseeTIME COMPLETED:
11:15 AM
NARRATIVE
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On 2/15/23 at 9:04am, Licensing Program Analyst Briana Plumboy, met with licensee Suhong Deng for an UNANNOUNCED ANNUAL INSPECTION. Present for this visit was 2 infants, 6 preschool age children, and fingerprint clear and associated assistant Jinmei Liang. The home was toured to conduct a Health and Safety Inspection. Hours of operation for day care are Monday through Friday, 7am until 5pm.

The home is 2 stories. The home consists of the following rooms: the ground level consist of a bathroom, bedroom, garage, and main common space. The upstairs consist of a living room, dining room, 2 bedrooms, hallway bathroom, and masterbedroom with bathroom. The home is neat and clean with heating and ventilation for safety and comfort. The licensee has requested the OFF LIMIT AREAS BE: the entire second level of the home and the garage. PER FIRE CLEARANCE THE SECOND FLOOR AND GARAGE ARE NOT PERMITTED TO BE USED AT ANYTIME BY CHILDREN IN CARE. The licensee has requested the following rooms be ON LIMITS - the entire ground level of the home except the garage. On limit areas consist of a bathroom, bedroom, and main common space. The ISOLATION AREA will be the bedroom located off the common space on the ground level of the home. The BACKYARD play area is completely fenced and children in care will play on the deck in the backyard only. There are toys and learning materials present at the facility during today's inspection. There is a hot tub located in the backyard and has a locked cover on it during today's inspection to prevent access to children in care.

The home has a fully charged fire extinguisher, working smoke detector, working carbon monoxide detector, working telephone. The licensee CPR and First Aid certificate is current and expires 3/5/24, and her assistant Jinmei's expires 12/3/2024. The licensee's mandated reporter training is complete and she received a certification of completion on 3/5/22 and licensee is aware when the mandated reporter training is available in her assistants native language, the assistant must complete the training. The licensee is in compliance with the immunization law. Today licensee is cited due to her assistant not having the provider immunization's on file. Per licensee, there are no firearms in the home. There are no pets in the home. All required licensing documents are posted and visible for public review. The licensee conducts and documents fire and disaster drills twice a year with the last one conducted on 2/6/23.
(4) Children files were reviewed, facility roster reviewed and copy obtained. The licensee is in ratio today. All REQUIRED forms are posted and visible for public review.
See 809-C and 809-D for continuance
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Briana Plumboy
LICENSING EVALUATOR SIGNATURE: DATE: 02/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/15/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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: DENG, SUHONG
FACILITY NUMBER: 015700348
VISIT DATE: 02/15/2023
NARRATIVE
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Incidental Medical Services (IMS) policy was discussed. 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: http://www.ada.gov/childqanda.htm

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

Licensee is reminded that ALL assistants, volunteers, and staff, that are 18 years of age or older must be fingerprint cleared and associated to this facility prior to being in the presence of children in care or an immediate civil penalty will be assessed from $100 to $3000 per person, per incident. Licensee was reminded of the responsibility as a mandated reporter. All forms can be downloaded at www.ccld.ca.gov



LPA discussed the safe sleep regulations with licensee Suhong Deng 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 Suhong Deng 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.

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

See 809-D cited during today's inspection as well as technical violation and advice provided. Appeal rights provided and discussed. Exit interview conducted and report was reviewed with licensee Suhong Deng.

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Briana Plumboy
LICENSING EVALUATOR SIGNATURE:

DATE: 02/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/15/2023
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Document Has Been Signed on 02/15/2023 11:04 AM - It Cannot Be Edited


Created By: Briana Plumboy On 02/15/2023 at 10:32 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: DENG, SUHONG
FACILITY NUMBER: 015700348

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/15/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Section Cited
Administration of Child Day Care Licensing
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Type B
Section Cited
HSC
1597.622(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above due to her assistant present today not having current immunizations on file which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/15/2023
Plan of Correction
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On or before 3/15/23, licensee will provide LPA Plumboy with the immunizations for her assistant. The immunizations include MMR, TDAP, and INFLUENZA (the influneza may be declined with a wriiten statement). Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Wynn Norona
LICENSING EVALUATOR NAME:Briana Plumboy
LICENSING EVALUATOR SIGNATURE:
DATE: 02/15/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/15/2023


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 02/15/2023 11:04 AM - It Cannot Be Edited


Created By: Briana Plumboy On 02/15/2023 at 10:32 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: DENG, SUHONG
FACILITY NUMBER: 015700348

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/15/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102418(g)
Immunizations
(g) The licensee shall document each child's immunizations as required by the California Code of Regulations, Title 17, Section 6070, and shall maintain such documentation for as long as the child is enrolled.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in 1 out of 4 files do not have an immunization record which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/24/2023
Plan of Correction
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On or before 2/24/23 licensee shall transfer C1 immunizations onto immunization cards and submit copies to LPA.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Wynn Norona
LICENSING EVALUATOR NAME:Briana Plumboy
LICENSING EVALUATOR SIGNATURE:
DATE: 02/15/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/15/2023


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