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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700366
Report Date: 10/30/2024
Date Signed: 10/30/2024 02:02:41 PM

Document Has Been Signed on 10/30/2024 02:02 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
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:LIU, LING CHUFACILITY NUMBER:
015700366
ADMINISTRATOR/
DIRECTOR:		LIU, LING CHUFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 398-7038
CITY:FREMONTSTATE: CAZIP CODE:
94536
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 4DATE:
10/30/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:30 AM
MET WITH:Ling Chu LiuTIME VISIT/
INSPECTION COMPLETED:
02:10 PM
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On October 30, 2024 Licensing Program Analyst (LPA) Randy Miranda met with licensee Ling Chu Liu for the purpose of conducting an unannounced annual inspection for health and safety. Living in the home is the licensee, her TB tested and fingerprint cleared two adult sons and adult daughter. Present in the home at the time of inspection was the licensee, one adult son, and four children in care (all infants). The hours of operation are Monday-Friday, 8:30am to 5:30pm.

The facility is a two-story home with 5 bedrooms and 3 bathrooms; a family room (with a fully screened fireplace); living room; utility room (converted to childcare room); kitchen; dining room; laundry room, attached 2-car garage; side and backyard patio areas. There is a child gate at the bottom of the stairs preventing children from accessing the upstairs area. The backyard contains 2 sheds, a covered and locked jacuzzi and a large patio area. There is a six-foot wood fence surrounding the backyard with gates serving as emergency exits.



Toxins, medicines, and hazardous items were inaccessible during today's inspection. However, cleaning compounds were observed to be on top of the off-limits kitchen counter. Per the licensee, the ISOLATION AREA will be in utility room daycare area away from the other children in care.

On-limit-areas include: Family room (day care area); dining room; utility room (day care area on left side of the kitchen); first floor full bathroom; outside main patio area off the family room on the east side of the of the home.

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Randy Miranda
LICENSING EVALUATOR SIGNATURE: DATE: 10/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/30/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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Document Has Been Signed on 10/30/2024 02:02 PM - It Cannot Be Edited


Created By: Randy Miranda On 10/30/2024 at 12:06 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
, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: LIU, LING CHU
FACILITY NUMBER: 015700366

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/30/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(a)(4)
Infant Safe Sleep
(a) There shall be one crib or play yard for each infant who is unable to climb out of the crib or play yard. (4) Mattresses shall be made specifically for the size crib or play yard in which they are placed.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in that the crib mattress is too small which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/04/2024
Plan of Correction
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Licensee will advise parents to find an appropriate size mattress for the crib or crib replacement. Licensee to send LPA photo proof of properly sized mattress or crib replacement.
Type B
Section Cited
CCR
102423(a)(2)
Personal Rights
(a) Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. These rights include, but are not limited to, the following: (2) To receive safe, healthful, and comfortable accommodations, furnishings, and equipment.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in two infants found sitting in a high chair, located in the dining room while assistant was changing an infant's diaper in another room, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/13/2024
Plan of Correction
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Place children in enclosed play area and not keep children in the high chair when not eating.
Licensee and assistants to watch video, then create an attendance sheet, with printed names and signatures. Send to LPA attendance sheet.
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:Wynn Norona
LICENSING EVALUATOR NAME:Randy Miranda
LICENSING EVALUATOR SIGNATURE:
DATE: 10/30/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/30/2020


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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
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: LIU, LING CHU
FACILITY NUMBER: 015700366
VISIT DATE: 10/30/2024
NARRATIVE
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Off-limit-areas include: The entire upstairs; kitchen (there is a child gate installed to prevent children from access); living room; downstairs bedroom; the attached 2-car garage; outside side yards (north and south patio areas); both sheds and a swing set (2 swings) on western side of back yard. All off limit areas will be inaccessible by closed and/or locked doors and visual supervision.

Upon arrival, licensee’s assistant granted LPA entry into the facility. While awaiting for an area to set up, LPA observed at approximately 8:50am, two infants in a high chair while the assistant was in another day care area changing an infant’s diaper. During the waiting period, assistant stated that the licensee was at the market. Licensee arrived shortly, approximately at 9:08am.



There were ample age appropriate toys that were observed to be safe and in good condition. The home and the day care area and rooms are neat and clean, with heating and ventilation for safety and comfort. There are two fully charged fire extinguishers. One (2A10BC) is wall mounted by the front door and the second one (3A40BC) wall mounted near the kitchen. The facility has multiple working (tested and functioning) smoke and carbon monoxide detectors. Fire and disaster drills are required to be conducted at least once every six months, the last drill was completed 4/02/2024. Considering today’s date 10/30/2024, disaster drils are four (4) weeks delayed. Per licensee, there are no firearms in the home.

During the inspection at approximately 9:38am, LPA observed in one of the cribs, a mattress that was not fitting and too small for the crib. The other three cribs were found to be in compliance with safe sleep regulations.

Children’s files were reviewed, a copy of the roster was taken for the office file. Licensee’s Pediatric CPR/First Aid certificate is current and expires 3/25/2025. Mandated reporter training was completed and expires on 9/08/2026. Licensee’s primary helper (adult son) CPR/1st Aid expires 9/09/2025 and Mandated Reporter expires on 9/06/2025. Licensee and helpers are in compliance with all immunization laws required for child care providers. LPA reminded the licensee of the following: Mandated Reporter certificate and CPR/First Aid certificate must be renewed every two years. Baby bouncers & drop-down cribs are not allowed at the day-care facility.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Randy Miranda
LICENSING EVALUATOR SIGNATURE:

DATE: 10/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2024
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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
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: LIU, LING CHU
FACILITY NUMBER: 015700366
VISIT DATE: 10/30/2024
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The licensee rents the property and carries childcare liability insurance through Charter Risk Management, underwritten by Mesa Underwriters Insurance Co. policy expires 6/02/2025. LIC9151 Property Owner Notification form completed and signed.

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.

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/.

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. 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.

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Randy Miranda
LICENSING EVALUATOR SIGNATURE:

DATE: 10/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2024
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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
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: LIU, LING CHU
FACILITY NUMBER: 015700366
VISIT DATE: 10/30/2024
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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 [email protected]. 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.


Two deficiencies were issued during today’s inspection. See LIC 809D.
Technical Advisories were issued during today’s inspection.
A notice of site visit was given and must remain posted for 30 days. Appeal Rights provided.
Exit interview conducted and report was reviewed with the licensee Ling Chu Liu.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Randy Miranda
LICENSING EVALUATOR SIGNATURE:

DATE: 10/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2024
LIC809 (FAS) - (06/04)
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