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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434412411
Report Date: 08/26/2021
Date Signed: 08/26/2021 02:37:15 PM

Document Has Been Signed on 08/26/2021 02:37 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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:LINGLI SCHOOL, LLCFACILITY NUMBER:
434412411
ADMINISTRATOR:JING XIAOFACILITY TYPE:
850
ADDRESS:951 DALE AVENUETELEPHONE:
(650) 386-5614
CITY:MOUNTAIN VIEWSTATE: CAZIP CODE:
94040
CAPACITY: 76TOTAL ENROLLED CHILDREN: 0CENSUS: DATE:
08/26/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:22 AM
MET WITH:Jing "Susan" XiaoTIME COMPLETED:
02:45 PM
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On Thursday, August 26, 2021 at 11:22 am, Licensing Program Analyst (LPA) Manel Estoesta conducted an unannounced Required 1 Year visit. LPA met with the Director Jing Xiao a.k.a. Susan and explained the nature of site visit. Present on this visit were 15 staff and 36 preschool children. Facility operates from Monday to Friday 8:30am to 6pm.

LPA toured the facility to conduct a Health and Safety Inspection. LPA notes that the Facility is licensed in Rooms 1, 2, 3, 4, 5, 6, & 7. Rooms 2, 3, & 4 operating days/hours are Monday to Friday 8:30 AM to 12:30 PM only. The Facility also has a school age program (#434412412) on site and that program is licensed in Rooms 2,3 and 4 and operating days/hours are 1 PM to 6pm PM Monday to Friday. The director understands that the preschool capacity is reduced by 45 children when other rooms are in use by the school age program. LPA observed the required posted materials, including the Facility License, Emergency Disaster Plan (LIC 610), Earthquake Preparedness Checklist (LIC 9148), Parents' Rights Poster (PUB 393), Personal Rights (LIC 613A), Child Car Seat Law (PUB 269), Menus, and Activity Schedule.

LPA observed that all rooms are clean and safe for all children and staff. The director states that the Facility has a third-party cleaning service that cleans the Facility Monday through Friday in the evenings. Drinking water is readily available for the children in each room and in the outdoor playground area. LPA observed solid waste containers with tight-fitting lids in each room. Staff and children's bathrooms are clean, sanitary, and operable. There are two separate staff bathrooms not utilized by the children which an isolated child can use if needed. The director stated that there are no weapons or firearms on the premises.

Facility does not provide transportation for children but Director understands that children cannot be left alone, unattended in park vehicles. First Aid Kit was inspected.

SEE 809 C.

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Manel Estoesta
LICENSING EVALUATOR SIGNATURE: DATE: 08/26/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/26/2021
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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: LINGLI SCHOOL, LLC
FACILITY NUMBER: 434412411
VISIT DATE: 08/26/2021
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Director stated that the children brings their own water bottle, snacks and lunch. Kitchen and storage areas are clean, free of litter & rubbish, and free of rodents and other vermin. Cleaning supplies are inaccessible to the children and stored in high cabinets inaccessible to children. Any poisons are stored in the locked storage cabinet, located near the kitchen area. Any medications at the Facility are stored in the kitchen area of the Facility separate from food products.

LPA observed all furniture and equipment is in good condition and safe for the children. The playground areas utilized by the children are surrounded by appropriate fencing and the outdoor surfaces are safe for the children. LPA observed that the outdoor equipment is age appropriate and in good condition. There is sufficient resilient materials and shade in the outdoor playground areas. LPA did not observe any bodies of water on the premises.

LPA reviewed children and staff files during today's inspection. Each child's file reviewed contains the Information and Emergency Information form (LIC 700). All director/teacher files reviewed contain the required transcripts/verification of experience. All staff have current CPR and First Aid certifications on file. The director understands that there shall be at least one person, with valid CPR and First Aid certifications, on site at all times or present during off-site activities (field trips).

Licensee [or facility representative] was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

The facility had a Fire Department Inspection on 04/2021 and the Fire Extinguisher was last serviced on 12/2020. Fire and Disaster Drill was last conducted on 04/2021.

SEE 809 C.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Manel Estoesta
LICENSING EVALUATOR SIGNATURE:

DATE: 08/26/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2021
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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: LINGLI SCHOOL, LLC
FACILITY NUMBER: 434412411
VISIT DATE: 08/26/2021
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Director stated that facility does handle medications and is providing Incidental Medical Services – IMS: Epinephrine and Inhaled Medication. LPA reviewed storage of medication and equipment/supplies and Facility's current IMS Plan for Epinephrine, and reviewed children’s, personnel, and administrative records. For IMS information, see Evaluator Manual – Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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.

LPA discussed, provided copies of PIN 21-21-CCP RELEASE OF THE WRITTEN DIRECTIVES FOR LEAD TESTING OF
WATER IN LICENSED CHILD CARE CENTERS PER AB 2370,PIN 20-03-CCLD introduces the Caregiver Background Check Bureau’s new background check system, Guardian and Lead Poisoning Facts Flyerto the director. For more information, please follow the linkhttps://cdss.ca.gov/inforesources/child-care-licensing/water-testing-information

No deficiencies issued during today's inspection.

A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE FRONT ENTRANCE TO THE FACILITY,
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Manel Estoesta
LICENSING EVALUATOR SIGNATURE:

DATE: 08/26/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2021
LIC809 (FAS) - (06/04)
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