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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015701081
Report Date: 07/16/2024
Date Signed: 07/16/2024 01:45:05 PM

Document Has Been Signed on 07/16/2024 01:45 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:CHEN, MEIFENGFACILITY NUMBER:
015701081
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 5CENSUS: 5DATE:
07/16/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:10 PM
MET WITH:Meifeng Chen- LicenseeTIME VISIT/
INSPECTION COMPLETED:
01:45 PM
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On 7/16/24 at 1:10pm, Licensing Program Analyst (LPA) Briana Plumboy conducted an unannounced case management inspection for the purpose of adding her backyard onto the on limit areas effective 7/16/24. The enclosed portion of the backyard located off the kitchen in the central part of the backyard may be utilized for children in care. The front yard is off limits to children in care per licensee effective 7/16/24. There are no swing sets present during today's inspection at the facility. Present for the inspection was 5 children in care as well as fingerprint clear and associated assistant Lin Gu.

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

No deficiency is cited today.

Exit interview conducted and report was reviewed with the licensee

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Briana Plumboy
LICENSING EVALUATOR SIGNATURE: DATE: 07/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/16/2024
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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