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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423704
Report Date: 04/15/2022
Date Signed: 05/10/2022 05:02:05 PM

Document Has Been Signed on 05/10/2022 05:02 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, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:TAM, WING YEE MAEGANFACILITY NUMBER:
013423704
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: DATE:
04/15/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Maegan Tam and Carol WongTIME COMPLETED:
11:30 AM
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On 4/15//22, at 9:40AM, Licensing Program Manager (LPM) Mayla Mendoza and Licensing Program Analysts (LPAs) Indira Loza and Nyeesha Blount arrived announced on a Pre-Licensing inspection and met with Licensee Maegan Tam and Carol Wong. There are no children in care during todays inspection. The purpose of the inspection was to grant a license for a small family daycare and to conduct a health and safety check. Operating hours will be 8:00AM to 5:00PM, Monday through Friday.

The home is single family home with two bedrooms and one bathroom. The on limit areas will be the living room, the dining room, the bathroom, and the first bedroom on the left from the hallway. The off limit areas will be the bedroom to the left of the bathroom, and the laundry room, which will be inaccessible by closed and/or locked doors or visual supervision. The ISOLATION AREA will be the first bedroom to to the left in the hallway. Outdoor play area will be in the two fenced in areas, one small area in the front of the home, and a larger play area on the side of the home. Both areas will be shared with the daycare next door, The Licensee was reminded that they are not to be co-mingling the children from both facilities. There are no pools, hot tubs or any other bodies of water during today's inspection.

The home has a fully charged 2A10BC fire extinguisher, a working smoke and carbon monoxide detector in the hallway and a first aid kit. Licensee has a working telephone. The Licensee's CPR and First Aid certificate is current and expires on 4/2024. Per Licensee, there are no firearms in the home. The Licensee was reminded of the responsibility as a mandated reporter and will provide proof of the required training for child care providers.

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.
Report continues on 809C.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE: DATE: 04/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/15/2022
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, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: TAM, WING YEE MAEGAN
FACILITY NUMBER: 013423704
VISIT DATE: 04/15/2022
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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-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.


For licensing updates email [email protected] and ask to be added to the email list.

Exit interview conducted and report was reviewed with the licensee
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE:

DATE: 04/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2022
LIC809 (FAS) - (06/04)
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