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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015701106
Report Date: 04/24/2024
Date Signed: 04/24/2024 10:55:21 AM

Document Has Been Signed on 04/24/2024 10:55 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:ZHANG, YINGCHUNFACILITY NUMBER:
015701106
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
04/24/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:36 AM
MET WITH:Yingchun Zhang- ApplicantTIME VISIT/
INSPECTION COMPLETED:
11:05 AM
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On 4/24/24 at 8:36am, Licensing Program Analysts Briana Plumboy and Randy Miranda, met with applicant Yingchun Zhang for an ANNOUNCED PRE LICENSING INSPECTION. The home was toured to conduct a Health and Safety Inspection. The applicant plans to operate the facility Monday through Saturday from 6:30am until 6:00pm.
The home is single story. The home consists of a living room, dining room, kitchen, larger bedroom with a bathroom inside, 2 bedrooms, hallway bathroom, and garage. The home is neat and clean with heating and ventilation for safety and comfort. The OFF LIMIT AREAS are the kitchen, larger bedroom with bathroom located inside, 2 bedrooms, and garage which will be inaccessible by closed and/or locked doors and visual supervision. The off limit areas have child safety knobs on the door handles during today's inspection. There are child safety gates located on both sides of the entrance to the kitchen. The ON LIMIT AREAS are the living room, dining room, and hallway bathroom. The ISOLATION AREA will be the dining room. Outdoor play area will be in the fenced backyard and the children in care will use the patio area and right side of the backyard. There is a garden located on the left side of the backyard and has a gate to prevent access to children in care to that area during today's inspection. There are toys and learning materials present during today's inspection and there are no pools, hot tubs or any other bodies of water on the premises during today's inspection. There are no toxins or hazardous items which could be accessible to children during today's inspection.
The home has a fully charged 3A40BC fire extinguisher, working smoke detector, working carbon monoxide detector, and working telephone. The applicant’s Health and Safety training is completed and CPR and First Aid certificate is current and expires 9/3/24. The applicant completed and received a certificate in mandated reporter training on 3/7/24. The applicant is in compliance with the immunization law which pertains to day care providers. The fireplace is barricaded with a couch and floor heaters are covered during today's inspection. Per applicant, there are no firearms in the home. A copy of the lease was reviewed and shows control of property. A packet of forms pertaining to the children’s files and facility files were reviewed and discussed. See 809-C for continuance
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Briana Plumboy
LICENSING EVALUATOR SIGNATURE: DATE: 04/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/24/2024
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: ZHANG, YINGCHUN
FACILITY NUMBER: 015701106
VISIT DATE: 04/24/2024
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LPA discussed the safe sleep regulations with applicant Yingchun Zhang and discussed the Child Care Licensing Safe Sleep webpage at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep, as an additional resource. LPA also informed 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.

Subscribe to CCLD important information - Child Care Centers and Family Child Care Homes: Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms.

To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-carelicensing/subscribe and select the Child Care option to receive email communication.

The applicant was reminded nothing shall hang over the infant cribs and not to swaddle infants while in care.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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

Applicant is reminded that ALL assistants, volunteers, frequent visitors, or adults living in the home, 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



See 809-C for continuance
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Briana Plumboy
LICENSING EVALUATOR SIGNATURE:

DATE: 04/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2024
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: ZHANG, YINGCHUN
FACILITY NUMBER: 015701106
VISIT DATE: 04/24/2024
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Licensee Yingchun Zhang is aware she should have knowledge of all Title 22 Regulations and follow all Title 22 Regulations at all times, as well as follow manufacture guidelines for all equipment in the facility.

During the exit interview, the applicant Yingchun Zhang confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

This home is recommended for licensing on 4/24/24. The licensee is aware the signature on this report confirm receipt of these documents. LPA asked the licensee if the licensee had any questions pertaining to any aspects including, but not limited to, any part of this report and of the documents given to the licensee, and per licensee, there are no further questions at this time. Licensee is aware at anytime she can reach out to LPA Plumboy or CCLD. This report shall remain on file for 3 years. Exit interview conducted licensee Yingchun Zhang.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Briana Plumboy
LICENSING EVALUATOR SIGNATURE:

DATE: 04/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2024
LIC809 (FAS) - (06/04)
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