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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434417366
Report Date: 09/27/2024
Date Signed: 09/27/2024 11:44:20 AM

Document Has Been Signed on 09/27/2024 11:44 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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:CHENG,HSIAO-YING&NAZARENO,REGINALD&HUANG,TIEN-HSINFACILITY NUMBER:
434417366
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 6CENSUS: 5DATE:
09/27/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:30 AM
MET WITH:Hsiao-Ying Cheng, Reginald Zazareno, Tien-Hsin HuangTIME VISIT/
INSPECTION COMPLETED:
12:00 PM
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Licensing Program Analyst (LPA) Mel Matos met with Hsiao-Ying Cheng, Reginald Nazareno, Tien-Hsin Huang, Licensees, for an unannounced Annual/Random inspection and capacity increase request. LPA was granted access to the home by the Licensees. LPA also observed five day care children (2 infants & 3 preschool) in the home during today's inspection. Licensees were operating within their capacity and ratio requirements. Licensees have been licensed as a small Family Child Care Home since September 6, 2023 and thus meet the one year minimum experience requirement to apply for the large Family Child Care Home License. LPA observed the required postings, including the facility license, near the front entrance to the home. Days and hours of operation are Monday - Friday from 8:30 AM to 6:00 PM. Licensees and one adult son (Lihung Huang) are the adults residing in the home. There is one minor child (9 years old) residing in the home.

LPA reviewed a current Child Care Facility Roster and Fire/Disaster drill log during today's inspection. The last fire/disaster drill was completed on July 30, 2024. Licensees state that they have liability insurance for the day care through DCI Insurance. LPA observed a valid insurance policy (exp: 01/2025) during today's inspection. Licensees have current CPR and First Aid certifications (exp: 07/15/2025) on file. Licensees have the required vaccines (MMR, Tdap, & flu - opt out) and are current with their Mandated Reporter Training for Child Care Workers. LPA reviewed five children's files and the files were complete with the required forms, including infant sleep logs. LPA reviewed three staff file (Licensees) and the files were complete with the required forms. Copy of lease agreement verifying control of property is on file. Property Owner/Landlord Notification (LIC 9151) and a signed Property Owner/Landlord Consent form (LIC 9149) form are on file.

LPA toured the indoor and outdoor areas of the home with the Licensees during today's inspection. Licensees have a working telephone in the home. The home is clean, orderly, (including heating/ventilation), and safe for the day care children. There are safe & age appropriate toys, play equipment, and materials for the children in the home. There are no wall heaters/open face heater units or stairs inside the home. Off limit areas inside the home: Bedroom #3, one bathroom, two barricaded fireplace units (located in the living room & family room), and attached garage. Off limit areas outside the home: right side area of the home and locked storage shed.

LPA observed a fully charged 3A40BC fire extinguisher, working smoke/carbon monoxide detectors, no bodies of water, and fenced backyard. Licensee states that she does not have any weapons in the home. Licensees has two snakes that are kept in an enclosure in an off limits bedroom of the home. All detergents, cleaning compounds, medications, and other similar items are inaccessible to children. Any poisons are locked in the attached garage, which is off limits.
SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Melvin S Matos
LICENSING EVALUATOR SIGNATURE: DATE: 09/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/27/2024
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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: CHENG,HSIAO-YING&NAZARENO,REGINALD&HUANG,TIEN-HSIN
FACILITY NUMBER: 434417366
VISIT DATE: 09/27/2024
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Licensees state that they provide all meals (snacks and lunch) to the day care children. Licensees understand that any food brought from home shall be labeled with each child's name and properly stored. Licensees have a first aid kit in the home which includes a touch less thermometer. Licensees state that nobody smokes and they understands that smoking is prohibited in the home. There are carbon monoxide detectors in the home.

Licensees do not administer medication to children. 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

Supervision of children was discussed with the Licensees and they understand that they must be present in the home during day care hours and ensure that the children are supervised at all times. Licensees understand their capacity/ratio options and they understand that they cannot have more than 14 children present in the home without at least two qualified adults present. Licensees state that a child will be isolated in the living room area if necessary due to illness or communicable disease. Licensees states that they do not transport any day care children. Licensees understand that children shall not be left unattended in parked vehicles and that car seats shall only be used for transportation and shall not be used for sleeping.
Hsiao-Ying Cheng, Reginald Nazareno, Tien-Hsin Huang, Licensees, were reminded that all adults 18 and over living or working in the home, 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 licensed Family Child Care Home. 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.

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

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process

Confirmation of fire inspection approval from the Sunnyvale Department of Public Safety was received today.

Exit interview conducted and report was reviewed with the Licensees, Hsiao-Ying Cheng, Reginald Nazareno, Tien-Hsin Huang. No deficiencies issued during today's inspection. Large Family Child Care Home license is approved effective today, September 27, 2024.

A Notice of Site Visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Melvin S Matos
LICENSING EVALUATOR SIGNATURE:

DATE: 09/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2024
LIC809 (FAS) - (06/04)
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