192004812-10-22-2019-33-CC-FVAZ-BH7QWA-20191022123136

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 192004812
Report Date: 10/22/2019
Date Signed: 10/22/2019 12:31:48 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	HU & CHU FAMILY CHILD CARE		FACILITY NUMBER:	192004812
ADMINISTRATOR:	LIN HU & DAVID CHU		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(626) 576-2672
CITY:	ALHAMBRA	STATE: CA	ZIP CODE:	91801
CAPACITY:	14	CENSUS: 11	DATE:	10/22/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:46 AM
MET WITH:	David Chu		TIME COMPLETED:	12:40 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	Licensing Program Analysts Fabiola Vasquez and Ariel Cazares conducted an unannounced Annual/Random inspection. LPA met with licensees, Lin Hu, and David Chu who guided analysts on a tour of the facility. There were 11 children present and two additional assistants. This is a two story home which consists of 4 bedrooms, 4 bathrooms, kitchen, dining room, living room, kitchenette , garage, frontyard and outdoor deck in back (fenced). Individuals residing in the home are two licensees and son. Areas accessible to children were inspected as follows: First floor with 2 bathrooms, 1 bedroom for napping, living room, and outdoor deck. Per licensee, areas off limits to children include: entire second floor which is barricaded with a kiddie gate, front part of the house which is also barricaded with a half door, and the garage. The entrance to the child care is in the rear area of the home. Days and hours of operation are Monday -Friday 8:00am-6:00pm. Licensee states that there are no weapons or firearms on the premises. LPA did not observe swimming pools or spas on the premises. The backyard is adequately fenced. There are age appropriate toys and equipment on the premises. The smoke detectors and carbon monoxide detectors are present in the facility and operational. Fire extinguisher was missing the proof of service tag. There is a properly secured fish tank outside on the deck. CPR Card is valid until: 7/2020, for both licensees. Child Care Roster , Disaster Drill Log, and Children's Records were reviewed and found complete. Mandated child abuse certificates are on file. All individual present have finger print clearance. Page 1 of 3

SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3439
LICENSING EVALUATOR NAME: Fabiola Vasquez	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 10/22/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2019

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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: HU & CHU FAMILY CHILD CARE	FACILITY NUMBER: 192004812
	VISIT DATE: 10/22/2019

NARRATIVE

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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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: http://www.ada.gov/childqanda.htm

The following was discussed with the Licensee:

Individuals who are 18 years of age or older living in the home must obtain a criminal record clearance. Individuals within one month of their 18th birthday must be fingerprinted immediately. Failure to obtain a criminal record background check clearances prior to initial presence in the home will result in an immediate $100.00 dollar or more per day Civil Penalty.

In the absence of the Licensee, a qualified adult must be present supervising the children; a qualified adult is an individual who has a valid and current adult/infant CPR & Pediatric First Aid certification and a valid criminal record clearance associated to the facility license.

A current roster of children enrolled must be available and maintained for a period of three years, even after children no longer are attending the facility. Annual fees must be paid promptly and by the due date or a late fee shall be assessed and/or the License shall be terminated.

The fire extinguisher type 2A-10BC must be serviced annually or as often as necessary. Smoke and Carbon Monoxide detectors should be checked, and batteries replaced as needed. Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your home.
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SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3439
LICENSING EVALUATOR NAME: Fabiola Vasquez	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 10/22/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2019

LIC809 (FAS) - (06/04)

Page: 2 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: HU & CHU FAMILY CHILD CARE	FACILITY NUMBER: 192004812
	VISIT DATE: 10/22/2019

NARRATIVE

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Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing. Fire and safety drills must be performed every six months and documented for review by the Department. Smoking is prohibited in a family child care home. Children and Staff records must be maintained and updated as needed and must be available for review by the Department.

Baby walkers, saucer chairs, bouncers or any similar items are prohibited. Sudden Infant Death Syndrome (SIDS) and Never-Shake-a-Baby were discussed. LPA provided a complete packet regarding Safe Sleep Awareness Campaign during today’s inspection.

All adults living and working in the home shall be made of aware of the Departments right to inspection authority, which includes but not limited to the right to enter the home when children are being cared for, interview children and adults and review documentation. Staff records were reviewed. Staff #1 and #2 did not have complete immunization records on file.

· It is recommended that First-Aid kits be available on premises.
· Outdoor supervision required at all times. If outdoor area not adequately fenced, provider must be with children at all times when outdoors.

Forms and updated can be found on the Department's website: www.ccld.ca.gov

There were deficiencies observed and cited during today's visit in accordance to the California Code of Regulations Title 22, Division 12, Chapter 1

Exit interview was conducted with David Chu. A copy of report and appeal rights were provided.

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SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3439
LICENSING EVALUATOR NAME: Fabiola Vasquez	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 10/22/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2019

LIC809 (FAS) - (06/04)

Page: 3 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: HU & CHU FAMILY CHILD CARE	FACILITY NUMBER: 192004812
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/22/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 11/05/2019 Section Cited	1 2 3 4 5 6 7	The family day care home shall maintain documentation of the required immunizations or exemptions from immunization, as set forth in this section, in the person’s personnel record that is maintained by the family day care home. This requirement has not been met as evidenced by staff file review finding that
	8 9 10 11 12 13 14	that assistants 1 and 2 did not have thier required immunizations. This requirement has not been met as evidenced by staff file review finding that	8 9 10 11 12 13 14
Type B 10/29/2019 Section Cited	1 2 3 4 5 6 7	The home shall contain a fire extinguisher and smoke detector device which meet standards established by the State Fire Marshal. This requirements has not been met as evidenced by fire extinguisher did not have the Annual service tag. This requirement has not been met as evidenced by staff file review finding that
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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: Brandi VanOosten	TELEPHONE: (323) 981-3439
LICENSING EVALUATOR NAME: Fabiola Vasquez	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 10/22/2019

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2019

LIC809 (FAS) - (06/04)

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