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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015701186
Report Date: 10/21/2024
Date Signed: 10/21/2024 11:35:32 AM

Document Has Been Signed on 10/21/2024 11:35 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:LIEN, SHUANGFACILITY NUMBER:
015701186
ADMINISTRATOR/
DIRECTOR:		SHUANG LIENFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 386-1921
CITY:DUBLINSTATE: CAZIP CODE:
94568
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
10/21/2024
TYPE OF VISIT:OfficeANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Applicant, Lien ShuangTIME VISIT/
INSPECTION COMPLETED:
11:40 AM
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On October 21, 2024, Regional Manager Loretta Dyson, and Licensing Program Analysts Jyoti Saini and Briana Plumboy met with applicant Lien Shuang, also known as Connie, for an informal meeting at the Oakland South Childcare Regional Office. The purpose of the meeting was to discuss the violations that occurred on September 17, 2024, at facility #15701016. These violations included using an off-limit area marked off by the Dublin Fire Department and the Community Care Licensing Division, operating the facility beyond its licensed capacity and unlicensed care being provided at the new location. During today’s meeting, Regional Manager Loretta Dyson also discussed the change of location application submitted by the licensee, Lien Shuang on 10/04/2024.

The applicant acknowledged that she understands the ratio requirements and capacity requirements. The Regional Manager (RM) Loretta Dyson discussed options with applicant regarding the schedules of children in care regarding ratio to maintain compliance. During the meeting, RM also informed applicant, Lien Shuang that a copy of the licensing report dated 09/17/2024, which documents Type A citations, must be provided to the parents/guardians of all currently enrolled children by the next business day. A signed Acknowledgment of Receipt of Licensing Report (LIC 9224) must be placed in each child's file for verification. A copy of LIC9224 was provided to the licensee during the meeting.

Regional Manager (RM) inquired about who lives at the new location. Applicant Lien Shuang stated that she is the only tenant residing in the home. Licensee Shuang was advised to provide an updated lease agreement to Community Care Licensing, reflecting that she is the only individual residing at the new location.

An exit interview was conducted, and the report was reviewed with applicant, Lien Shaung.

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE: DATE: 10/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/21/2024
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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