Pre-licensing visit·August 10, 2023

Page 1 Licensing Program Analyst (LPA) Oscar Huang conducted an announced, scheduled Pre-Licensing inspection in response to Applicant, Sixin Chen request of applying at small FCCH at 555 Pine Avenue, Sunnyvale, 94085. LPA explained the nature of today\342\200\231s inspection to Applicant. Present is applicant only. The adults live in the home will be Applicant and her two tenants. Applicant leases the house. Because the applicant rents/leases the home, proof of landlord notification is required. LPA observed the Property Owner/Landlord Notification form (LIC9151) was submitted and is on file, and the applicant also obtained a signed Property Owner/Landlord Consent form (LIC 9149) and is on file. Smoke and carbon monoxide detectors were tested and proved to be functioning. The home\342\200\231s disaster plan of action was discussed along with the requirement for the home to conduct and document fire and disaster drills at least once every six months. LPA reminded Applicant that smoking is not allowed in family childcare homes and baby walkers shall not be allowed on the premises of the family childcare home in accordance with Health and Safety Code Section 1596.846(b) and (c). Days and hours of operation will be Monday through Friday 8:30AM to 6:00PM . Applicant has documented proof of immunity against Measles, Pertussis, proof of cleared Tuberculosis, and statement of not taking Influenza in this season. The applicant's certification of completion of the AB1207 Mandated Reporter Training exp 06/17/2025, his Pediatric CPR & First Aid certifications are also current exp 2/2025. 8 hours of Preventive Health and Safety certificate on 6/23/2023. The applicant and her tenants had clearances for Criminal Record and Child Abuse Index Background Check. Page 2 Applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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. LPA inspected the indoor and outdoor areas of the home. Off limits areas in the home are bedroom #1 & #3, bathroom #2, kitchen, and garage. The home is with a fully fence in backyard and will be use for outdoor activity. Off limit area in the both side yards beyond gate and fences to ensure inaccessible to children. LPA observed appropriate children\342\200\231s play structure and toys. Applicant states he will be supervising the children while they participate in all outdoor activities. No Bodies of water observed. The home is clean and orderly, with heating and ventilation for safety and comfort of children in care. Applicant stated that there are no weapons such as firearm stored on the premises. Detergents, cleaning compounds, sharps, medicines, and other items which could pose a danger if readily available to children were stored where they are inaccessible, out of reach of children. The home has blocked fireplace. LPA reminded Applicant that poisons need to be locked. Applicant stated that the form of discipline to be used are talking and redirecting the children. Applicant understands that children's personal rights should not be violated; including no corporal punishment. Applicant stated that he understands that the children have personal rights that cannot be waived or abridged regardless of consent or authorization from the child\342\200\231s authorized representative. LPA informed Applicant that if he decides to not carry liability insurance for the Family Day Care, he will have to maintain in children\342\200\231s file with an affidavit regarding liability insurance signed by each parent of the children that will be enrolled. Page 3 LPA reviewed with applicant the LIC 311D, Forms/Records to Keep In Your Family Child Care Homes, children\342\200\231s forms/records, facility forms/records, and information to be posted. Entrance Checklist was provided to the applicant. Applicant is encouraged to visit the Department\342\200\231s website at www.cdss.ca.gov [Shortcut: www.ccld.ca.gov ] to access resources for Providers, Regulations, Online option to pay Annual License fee, Adoption of Laws, etc. LPA also discussed with Applicant about the continuing requirements, which include but are not limited to the following topics: (1) Separating sick children when they show signs of illness; (2) Supervision of Children; (3) Capacity Options; (4) transportation of children; (5) Procedures for Reporting Suspected Child Abuse and Unusual Incidents/Injuries; LPA discussed the safe sleep regulations with applicant 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 applicant 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. Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication. Page 4. 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) or (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 . On this date, 06/22/2023, the California Attorney General - Megan\342\200\231s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ. Applicant was informed of the MyChildCarePlan.org site, 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. 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 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 . Exit interview conducted and report was reviewed and verbally translated into Chinese with the applicant, Sixin Chen. Based on today's inspection, LPA advised Applicant that a Small Family Child Care Home license will be approved pending on Licensing Management final review and approval and receive the completion of the following: 1. Associating/Transferring the tenant criminal background clearance to the facility. 2. Installing open heater screen to prevent child access