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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434416336
Report Date: 01/14/2025
Date Signed: 01/14/2025 04:30:22 PM

Document Has Been Signed on 01/14/2025 04:30 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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:CHANG, CHIH & YI, BINGXINFACILITY NUMBER:
434416336
ADMINISTRATOR/
DIRECTOR:		CHIH C./BINGXIN Y.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(909) 516-8048
CITY:SAN JOSESTATE: CAZIP CODE:
95117
CAPACITY: 14TOTAL ENROLLED CHILDREN: 10CENSUS: 7DATE:
01/14/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:50 PM
MET WITH:Chang, Chih and Yi,BingxinTIME VISIT/
INSPECTION COMPLETED:
03:50 PM
NARRATIVE
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Licensing Program Analyst (LPA) Kate Huang met with Licensees, Chih Chang & Bingxin Yi (Husband & Wife) for an unannounced annual inspection. LPA explained the nature of today’s inspection to Licensees. Present were licensees, 5 preschoolers and 2 infants during today's inspection. Days and hours of operation are Monday to Friday, 8:00am to 6:00pm. The adults that reside in the home are licensees.

LPA toured the indoor and outdoor areas of the home during today's inspection with the licensee. Required materials were observed posted near the entrance. LPA observed that two infants are sleeping in the play yards with loose blankets. Based on records review, these two infants are 17 months old.

LPA observed sufficient materials, toys, and play equipment for the day care children. The indoor and outdoor areas are all clean and orderly. The home has heating and ventilation for comfort of children. Licensee stated that there is one dog living in the facility. Licensee stated that the dog is usually in the bedroom or in the yard where children cannot get close, and the dog never has the chance to contact with children.

LPA observed a fully charged fire extinguisher and working smoke/carbon monoxide detectors. The Licensee states that she does not have any weapons in the home. All detergents, cleaning compounds, poisons, medications, sharp objects and other similar items were observed to be stored inaccessible to children. Licensee understands that smoking is prohibited in the home.

LPA observed two licensees have current CPR and First Aid certifications which expire on 07/09/2025. LPA observed a current roster of the children and a fire and disaster drills log which is to be done every six months. The last drill was conducted on 10/05/2024. LPA reviewed 5 children's files. All the required documents are in the children's files. Infants' records have individual infant sleeping plans and every 15 minutes checking documents. LPA reviewed staff's records. Two licensees have all the required documents.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Linke Huang
LICENSING EVALUATOR SIGNATURE: DATE: 01/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/14/2025
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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Document is an Amendment of Original Document on 01/21/2025 11:15 AM


Created By: Linke Huang On 01/14/2025 at 01:59 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: CHANG, CHIH & YI, BINGXIN
FACILITY NUMBER: 434416336

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/14/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(b)
Infant Safe Sleep
(b) Cribs or play yards shall be free from all loose articles and objects.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in [count] out of [total count] [(objects) (persons)] [identifiers] which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date:
Plan of Correction
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Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Gladys Kuizon
LICENSING EVALUATOR NAME:Linke Huang
LICENSING EVALUATOR SIGNATURE:
DATE: 01/14/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/14/2025


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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: CHANG, CHIH & YI, BINGXIN
FACILITY NUMBER: 434416336
VISIT DATE: 01/14/2025
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Licensee 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.

LPA discussed the safe sleep regulations with licensee. LPA emphasized the risk of using loose blankets when infants are sleeping in the cribs or play yards and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource.

LPA also informed licensee 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 stated that she never provided medicine to children. Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. 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/.

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

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

As a result of today's inspection, one Type B deficiency was cited.

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

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.

Exit interview conducted and report was reviewed with the licensee, Yi,Bingxin in Mandarin.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Linke Huang
LICENSING EVALUATOR SIGNATURE:

DATE: 01/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2025
LIC809 (FAS) - (06/04)
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