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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434412281
Report Date: 10/02/2024
Date Signed: 10/02/2024 02:36:35 PM

Document Has Been Signed on 10/02/2024 02:36 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:ZHENG, VERA & XU, BAIRONGFACILITY NUMBER:
434412281
ADMINISTRATOR/
DIRECTOR:		ZHENG, VERA & XU, BAIRONGFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 823-3396
CITY:MOUNTAIN VIEWSTATE: CAZIP CODE:
94043
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
10/02/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:45 PM
MET WITH: Vera Zheng & Bairong Xu TIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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On October 2, 2024 at 12:45 PM, Licensing Program Analyst (LPA) Elimika Woods met with licensee's Vera Zheng & Bairong Xu for an Unannounced Annual/Random Inspection. LPA disclosed the purpose of the inspection and was granted entry into the facility by the licensee's. All adults subject to criminal background review have obtained criminal record clearance. There are nine children present during today’s inspection, two infant and seven preschool age children. The licensee is in ratio today. The licensee's stated that the facility operates from Monday to Friday 8:00 AM to 6:00 PM.

The off-limits will be made inaccessible by closed and/or locked doors and visual supervision. There's a gate at the kitchens entrance to prevent children access to the area. LPA checked the cabinets in the on limits areas which includes the living room, hallway bathroom, bedroom, hallway closets, and any other cabinets or drawers accessible to children in care and did not observe any hazardous materials or toxins accessible to children during today’s inspection. At 12:30 PM, LPA inspected the backyard area to make sure that there are no pools, hot tubs or any other bodies of water present that violates the childcare licensing laws and there were none, during today's inspection.

The OFF-LIMIT AREAS are bedroom #2 & #3, kitchen, & garage

The ON-LIMIT AREAS is the additional bedroom, hallway bathroom, living room, and backyard

LPA toured the facility inside and out to conduct a Health and Safety inspection. The home is a single story home with 3 bedrooms, 1 bathroom, living room, kitchen, attached two garage, and back yard. This home was clean and orderly, with heating and ventilation for the safety and comfort of children.



LPA tested the dual smoke and carbon monoxide detector in the living room and hallway found them to be functioning properly. The facility has a fully charged 2A10BC fire extinguisher which meets standards established by the State Fire Marshal in the kitchen, hanging on the wall The licensee also has a first aid kit that she keeps on a table at the front entrance of the home. The Isolation area of the home will be the bedroom with the sliding door, away from other children in care.

See 809-C for continuance.
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Elimika Woods
LICENSING EVALUATOR SIGNATURE: DATE: 10/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/02/2024
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 3
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: ZHENG, VERA & XU, BAIRONG
FACILITY NUMBER: 434412281
VISIT DATE: 10/02/2024
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This home has wall heaters and a fireplace that are blocked to prevent access by children in the hallway and in the living room. LPA asked the licensee does she transports children and the licensee stated that she does not transport children. During the record review LPA Woods checked the Health Records of the licensee's, and children and found that the licensee's are following the immunization laws which pertain to all childcare providers. All required forms are posted and visible for public review.

The Backyard area is the fully fenced backyard and LPA observed that it is free from defects or dangerous conditions. During today's inspection, there are no play structures which are required to be anchored. There are ample age-appropriate toys that appear to be safe and in good condition. The backyard area sits on top of a deck that wraps around to the right side of the backyard. There's a shed with a lock to prevent children access to equipment on the right side of the backyard..

At 12:45 PM, LPA requested and reviewed the files of three (3) children in care. All children’s files contain Immunization, Identification & Emergency Information, Parent's Rights, and Medical Consent forms. The licensee conducts and documents fire and disaster drills twice a year with the last one conducted on 08/22/24. The licensee's Health and Safety training is completed, and CPR and First Aid certificate is current and expires on 12/2025. The licensee's have completed mandated reporter training on 03/24/2024. Per licensee there are no weapons of any kind in the home.

Effective August 1, 2003, California Law requires Family Child Care Home licensees to report unusual incidents or injuries to children in care to child's parents and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624B). Incidents must be reported within 24 hours by phone, fax, or electronic mail. LPA informed the licensee's that all forms can be downloaded at www.ccld.ca.gov and encouraged the licensee to email childcareadvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list. The licensee's was also reminded that Mandated Reporter Training ("General" and "Child Care Providers") is required for all staff and is to be renewed every 2 years by visiting www.mandatedreporterca.com.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02CCP. 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: https://www.ada.gov/resources/child-care-centers/.



See 809-C for continuance.
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Elimika Woods
LICENSING EVALUATOR SIGNATURE:

DATE: 10/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/02/2024
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: ZHENG, VERA & XU, BAIRONG
FACILITY NUMBER: 434412281
VISIT DATE: 10/02/2024
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LPA discussed the safe sleep regulations with licensee 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 licensee's 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.

Licensee's was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

The licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, the LICENSEE's Vera Zheng & Bairong Xu, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

There are no deficiencies cited today. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensees Vera Zheng & Bairong Xu.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Elimika Woods
LICENSING EVALUATOR SIGNATURE:

DATE: 10/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/02/2024
LIC809 (FAS) - (06/04)
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