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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004965
Report Date: 12/02/2022
Date Signed: 12/02/2022 11:42:43 AM

Document Has Been Signed on 12/02/2022 11:42 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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:YANG, DANFACILITY NUMBER:
414004965
ADMINISTRATOR:YANG, DANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 283-6272
CITY:FOSTER CITYSTATE: CAZIP CODE:
94065
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
12/02/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:27 AM
MET WITH:Dan YangTIME COMPLETED:
11:57 AM
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On 12/2/2022, Licensing Program Analyst (LPA), Hanson Leong, conducted a scheduled, pre-licensing inspection with the Applicant, Dan Yang. The applicant requested a departmental visit after applying for a Large Family Child Care Home License. Because the applicant does not have the required one year of experience working in a child care setting, the LPA has informed the applicant that this visit would be for the purpose of obtaining a license for a Small Family Child Care Home. The LPA informed the applicant that she could apply for a Large Family Child Care Home License after one year of experience with her Small Family Child Care Home License. The LPA was granted entry by the applicant. The LPA explained the purpose of the visit to the applicant. Guardian, the department's system for conducting background checks, has confirmed that all the individuals listed on the facility’s roster have been granted permission to work or be present in a childcare facility.

The applicant rents the home. The applicant intends to open from 8:30am to 6:00pm, Monday through Friday. Before children enroll, the applicant states that she will purchase liability insurance for her home day care. The LPA informed the applicant that if she does not purchase insurance for her childcare, she must notify the parents using the LIC 282 form. The applicant plans to care for children ranging in from six months to school age. .

Day care area(s): Living Room Bathroom #1, Bedroom # 4, Hallway to Backyard, and Backyard,

Off-limits area(s): Kitchen, Dining Room, Garage, Bedroom #1, #2 and #3. The applicant is aware off-limits areas are not to be used during business hours

Both LPA and the applicant conducted a health and safety inspection of the home. The house is clean and safe, with a working smoke, carbon monoxide detector and a fire extinguisher. The applicant has a first aid kit that is fully stocked with all the necessary supplies for treating injuries. There are no bodies of water in the residence. The applicant has garbage cans with tightly fitting covered lids. At the home, the children in ***See Page 2 for continuation***

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE: DATE: 12/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/02/2022
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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: YANG, DAN
FACILITY NUMBER: 414004965
VISIT DATE: 12/02/2022
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care have access to age-appropriate toys and equipment. The LPA reminded the applicant that baby walkers, bouncers, jumpers, and other similar equipment should not be used on children who are in care.

The applicant has a designated cell phone and is aware that it must be kept in the home during day care hours. According to the applicant, there are no firearms or weapons in the home. One of the bedrooms will be the isolation area for a sick child. All hazardous materials and toxins are kept out of children's reach and are inaccessible. The applicant intends to serve food to the children. The applicant will provide resting mats and cribs for the children while they are napping.

The LPA reminded the applicant that the CPR and First Aid training must be renewed every two years. The applicant has proof that she has received the MMR and TDAP vaccinations. The applicant has completed the Mandated Reporter Training. The LPA reminded that the Mandated Reporter Training must be renewed every two years.

The LPA informed the applicant that emergency disaster drills should be conducted at least once every six months and that the date and time of the drill should be recorded. If the applicant provides care to the seventh and eighth child, who must be school aged, parent notification and landlord consent is required. The following is required to be posted in an accessible location in view of parents: Emergency Disaster Plan (LIC 610), Parent's Rights (LIC 995A), and License (once received).

The LPA discussed the safe sleep regulations and the Child Care Licensing Safe Sleep with the applicant, webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. The LPA also informed the applicant 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

Incidental Medical Services (IMS) policy was discussed with the applicant. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) ***See Page 3 for continuation***

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:

DATE: 12/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2022
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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: YANG, DAN
FACILITY NUMBER: 414004965
VISIT DATE: 12/02/2022
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toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to the publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

A packet of forms pertaining to the children’s files and facility files were reviewed and discussed with the applicant. The applicant was advised all assistants, volunteers, frequent visitors or adults living in the home, over the age of 18 must be fingerprint cleared, associated to the home and have proof of immunization, prior to having any contact with the children in care. Failure to do so could result in an immediate civil penalty of $100 per person, each day.

The applicant was informed that as of September 1, 2016, a person may not be employed or volunteer at a child care facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662. The LPA reviewed AB 1207 with the applicant.

On 11/18/2022, the fire department approved the facility's fire clearance. When the applicant is ready to apply for a Large Family Child Care Home License, the LPA informed the applicant that the facility may use the fire clearance that she received from the fire department on 11/18/2022.

The applicant was advised to contact San Bruno Regional Office for concerns or questions. Desk Duty is available Mon-Fri, 8:00am to 5:00pm at (650) 266-8800. Forms and regulations are made available at www.cdss.ca.gov/inforesources/Community-Care-Licensing.



The applicant will not be recommended for a license until she purchases and provides photographic evidence of resting mats located within her facility.

A copy of the report was given to the applicant

An exit interview was conducted, and the report was reviewed with the Applicant, Dan Yang

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:

DATE: 12/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2022
LIC809 (FAS) - (06/04)
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