<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 435700335
Report Date: 07/19/2022
Date Signed: 07/19/2022 12:12:23 PM

Document Has Been Signed on 07/19/2022 12:12 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:ZHENG, XINGXINFACILITY NUMBER:
435700335
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 5DATE:
07/19/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:53 AM
MET WITH:Xingxin ZhengTIME COMPLETED:
12:30 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On Tuesday, July 19, 2022 at 10am, Licensing Program Analyst (LPA) Manel Estoesta conducted an unannounced Required One (1) Year Required visit. LPA met with the Licensee Xingxing Zheng. Present on this visit were Licensee's spouse, Licensee's Assistant Lei Xu, four (4) preschool children and one (1) infant child. The licensee's hours of operation will be from Monday to Friday 8:30 AM to 5 PM.

LPA toured the facility to conduct a health and safety inspection. The home is a two-story home. The home is neat and clean with central heating and ventilation for safety and comfort. The home does not have a fireplace.
The OFF-LIMIT AREAS are the entire second 2nd floor, kitchen, garage, backyard and laundry room will be inaccessible to children by locked doors, safety gates and visual supervision.

The ON-LIMIT AREAS are living room (children activities), second living room (napping area), dining room, hallway bathroom in the first floor and the front yard.

The designated isolation area will be living room. The front will be a designated outdoor play area that is fully fenced. The outdoor area has age appropriate toys that appear to be clean and free from defects and dangerous conditions. There are no pools, hot tubs or any other bodies of water. All hazardous materials and toxins are kept out of reach from children and are not accessible. The home has a charged 2A10BC fire extinguisher, working combination of smoke detector and carbon monoxide, working cell phone and fully stocked first aid kit. Per applicant, there are no firearms on the premises.

The licensee conducts and documents fire and disaster drills twice a year with the last one conducted on 1/23/2022. Licensee owns the house and the facility does not carry childcare liability insurance or a bond and maintain the signed form LIC 282 AFFIDAVIT REGARDING LIABILITY INSURANCE.



SEE 809 C.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Manel Estoesta
LICENSING EVALUATOR SIGNATURE: DATE: 07/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/19/2022
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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: ZHENG, XINGXIN
FACILITY NUMBER: 435700335
VISIT DATE: 07/19/2022
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Continuation.

The licensee CPR and First Aid certificate and expires on April 2023. The licensee completed the Mandated Reporter General Training and Child Care Providers training online at https://mandatedreporterca.com/ on 07/23/2023. Licensee has records of Measles and Pertussis immunization and TB clearance. The Licensee declined the Influenza vaccination and LPA reminded Licensee that only the Influenza vaccination can be decline with a written declination.

Facility roster of children was reviewed, and a copy was obtained. Children’s files were reviewed, which included records of receipt for Parents' Rights Notice, Identification and Emergency Information, Consent for Emergency Medical Treatment form, and Immunization. The licensee is in ratio today.

Licensee stated that she does not transport children at this time. Licensee has a current and valid Driver License. Licensee understands that children cannot be left in parked vehicles unattended at any time, the motor vehicles used to transport children in care shall be maintained in safe operating conditions and all vehicle occupants must be secured in an appropriate restraint system.

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/inspection-process.

Licensee was 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 provided copies of the LIC 311 D, PIN 20-24-CCP, PIN 22-10-CCP and Lead FAQs.



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

DATE: 07/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2022
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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: ZHENG, XINGXIN
FACILITY NUMBER: 435700335
VISIT DATE: 07/19/2022
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Continuation.

Licensee also submitted a Large Family Child Care Home Application and the Oakland Child Care Licensing Office received the application.

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-and-resources/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.

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

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

There are no deficiencies cited on this visit.

Exit interview conducted and report was reviewed with the licensee, Xingxin Zheng.

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Manel Estoesta
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2022
LIC809 (FAS) - (06/04)
Page: 3 of 3