192006528-7-1-2019-33-CC-JHUA-BDNLR7-20190701085840

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 192006528
Report Date: 07/01/2019
Date Signed: 07/01/2019 08:58:45 AM

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:	HUANG FAMILY CHILD CARE		FACILITY NUMBER:	192006528
ADMINISTRATOR:	HUANG, PEI		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(626) 280-4816
CITY:	ROSEMEAD	STATE: CA	ZIP CODE:	91770
CAPACITY:	14	CENSUS: 6	DATE:	07/01/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:02 AM
MET WITH:	Pei Huang		TIME COMPLETED:	09:10 AM

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	This is an unannounced Random inspection conducted today by Licensing Program Analyst, Jennifer Hua. LPA met with Licensee and her husband Xiang Kong, who guided analyst on a tour of the facility. Child care areas identified were inspected. This is a single story home. Per licensee, her and her spouse reside at facility and 0 minors. The home was inspected for safety, comfort, cleanliness, telephone service, heating, lighting and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children. The home was inspected as follows: Living room, one bedroom (use for napping), bathroom, fenced carport. The rest of the home are off limits. Fenced carport is used for children's outdoor play. Licensee stated that the cars are moved out of the carport when the children play outdoors. Per Licensee there are no weapons, firearms in the facility at this time. There were no bodies of water observed on the premises. There are age appropriate toys and equipment on the premises. The required fire extinguisher (2A 10BC) and smoke/carbon monoxide detectors are in operable condition. LPA observed that licensee has current certificate in Pediatric CPR/First Aid. Certificate will expire on 1/12/21. Fire extinguisher was serviced on 1/9/19. The following were discussed: Individuals who are 18 years of age or older living/working in the home must be finger print cleared prior to presence in the facility. Individuals within one month of their 18th birthday must be fingerprinted immediately. Adults living or working at the facility are DOJ cleared.

SUPERVISOR'S NAME: Katherine Harewood	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Jennifer Hua	TELEPHONE: (323) 981-3375
LICENSING EVALUATOR SIGNATURE:	DATE: 07/01/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2019

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: HUANG FAMILY CHILD CARE	FACILITY NUMBER: 192006528
	VISIT DATE: 07/01/2019

NARRATIVE

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Rooms that are off-limits need to be made inaccessible during operating hours. No smoking, No infant walkers, Johnny jumpers, exersaucers, bouncers and any other item that falls into that category, earthquake – fire, disaster drills and safety, posting requirements, children records requirements, mandated child abuse and injury/ death reporting, criminal records, child abuse clearance and criminal records transfer requirements, SIDS, Never Shake A Baby, A Child Care Provider's Guide to Safe Sleep was provided to licensee. Drills conducted on 6/3/19. Affidavit for Liability Insurance form in children's files. Licensee was informed to complete the Mandated Reporter Training on department website at http://www.mandatedreporterca.com/ when training is available in her language.

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) 514-0388 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

· Dog(s) and or pets should be isolated from children in care. No pets
· It is recommended that a First Aid kit 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.

No Deficiency cited.

Exit interview was conducted with licensee. Site visit notice posted. And Licensee advised to keep notice posted for 30 days or a civil penalty of $100 will be assessed.

Web site address to order forms: http://www.dss.cahwnet.gov/cdssweb/On-lineFor_293.htm#l
INTERNET ADDRESS: http://www.ccld.ca.gov – To access licensing forms, updates and Title 22.

SUPERVISOR'S NAME: Katherine Harewood	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Jennifer Hua	TELEPHONE: (323) 981-3375
LICENSING EVALUATOR SIGNATURE:	DATE: 07/01/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2019

LIC809 (FAS) - (06/04)

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