197494854-7-29-2021-30-CC-LJCS-C5DN4E-20210729100751

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197494854
Report Date: 07/29/2021
Date Signed: 07/29/2021 10:08:09 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	ZHOU FAMILY CHILD CARE		FACILITY NUMBER:	197494854
ADMINISTRATOR:	ZHOU, XIN YAN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(562) 706-8300
CITY:	TORRANCE	STATE: CA	ZIP CODE:	90502
CAPACITY:	14	CENSUS: 0	DATE:	07/29/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Xin Yan Zhou		TIME COMPLETED:	10:30 AM

NARRATIVE

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On 7/29/2021 at 9:00AM, Licensing Program Analysts (LPAs) Lillian Casillas and Judy Laureano conducted an announced Pre-Licensing Inspection for a Change of Location. LPAs met with Licensee, Xin Yan Zhou, who guided LPAs on a tour of the inside and outside of the Family Child Care Home. LPAs observed 0 adults and 0 children in care. Hours of operation are scheduled for Monday through Friday, 8:00AM-6:00PM.

Licensee is applying for a Large Family Child Care Home with maximum capacity of 14 children, ages 0 to 13 years old.

This is a single-story house with 3 bedrooms, 2 bathrooms, living room, kitchen, family room, laundry room, front yard, backyard, and detached garage. Childcare areas are: living room, family room, bathroom 1, and backyard. Off-limits areas are: bedroom 1, bedroom 2, bedroom 3, bathroom 2, kitchen, garage, laundry room, and front yard.

Indoor

LPAs entered the property through the main entrance which leads into the living room. Licensee stated the living room is the primary napping area for infants. In the living room, LPAs observed 4 pack n plays with a child safety gate blocking the room from the rest of the house. LPAs also observed hand sanitizer and a touchless thermometer, per COVID-19 guidelines. In this room, LPAs observed a functioning smoke detector. Bathroom 1 is located in the hallway across from the kitchen. LPAs observed another functioning smoke detector in the hallway. In the bathroom, LPAs observed 1 sink, 1 bathtub, and 1 toilet. Licensee stated only diapers and wipes will be placed in the plastic cubbies situated across from the sink. In the family room, LPAs observed 2 couches, 2 children’s tables with chairs, 1 piano, cubbies, age-appropriate toys and books, and a fireplace that is covered with a metal screen behind the cubbies. LPAs observed a functioning smoke detector and carbon monoxide detector in this room as well. LPAs observed two sliding doors: one leads to the backyard, the other
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SUPERVISOR'S NAME: Maureen Neal	TELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Lillian J Casillas	TELEPHONE: (424) 301-3097
LICENSING EVALUATOR SIGNATURE:	DATE: 07/29/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2021

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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: ZHOU FAMILY CHILD CARE	FACILITY NUMBER: 197494854
	VISIT DATE: 07/29/2021

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leads to the driveway. Licensee stated the sliding door that leads to the driveway will remain locked during hours of operation.

Indoor Off-Limits
LPAs observed a child safety gate blocking the kitchen from the hallway. In the kitchen, LPAs observed a clean and organized refrigerator. Licensee stores cleaning products underneath the kitchen sink. The laundry room can only be accessed via the kitchen and includes a door that leads to the driveway. LPAs observed a child safety gate in the hallway that leads to all 3 bedrooms.

Outdoor
Licensee stated that children play in the enclosed backyard. LPAs observed 3 play structures atop of astroturf, a child safety gate blocking the backyard from the driveway, a child safety gate blocking the backyard from the side yard, and a gate blocking the backyard from the area behind the garage. Licensee stated the side door and window to the garage will always remain locked during hours of operation. LPAs observed a non-functioning built-in grill. Licensee confirmed the grill is not in use. LPAs observed a small door to the chimney, which Licensee stated is locked at all times.

Outdoor Off-Limits

LPAs observed a garage and driveway that are made inaccessible through a child safety gate and key locks. The front yard is off-limits.

Licensee states there are no firearms or weapons of any kind in the facility at the time of the visit. Upon review of child files, LPAs observed all required documents according to Title 22 Regulations. On the parent board in the living room, LPAs observed the Emergency Disaster Plan and Notification of Family Child Care (PUB394).
LPAs also observed a First-Aid Kit located in the living room. All electrical outlets have protective covers.

Discussed topics:
Baby Walkers/etc Prohibited. Licensee was made aware that state law prohibits baby walkers, bouncy seats, exersaucersand any other items that fall into that category. Health & Safety Code 1596.846(b) and (c).
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SUPERVISOR'S NAME: Maureen Neal	TELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Lillian J Casillas	TELEPHONE: (424) 301-3097
LICENSING EVALUATOR SIGNATURE:	DATE: 07/29/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2021

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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: ZHOU FAMILY CHILD CARE	FACILITY NUMBER: 197494854
	VISIT DATE: 07/29/2021

NARRATIVE

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Smoking Prohibited. Licensee was advised that regulation prohibits the smoking of tobacco in a private residence licensed as a family child care home during the hours of operation. Health & Safety Code 1596.795(a).

SIDS & Shaken Baby Syndrome Awareness. Licensee was reminded that all infants must be placed on their backs when sleeping to prevent S.I.D.S. (Sudden Infant Death Syndrome), and to prevent the Shaken Baby Syndrome, Never shake a baby!

High Chair & Car Seat Awareness. Licensee was also reminded that only children eating may be in high chairs and that car seats are utilized only for transportation.

Parent’s Rights Notification. The "Notification of Parent's Rights" (PUB394) was discussed with the Licensee and the Licensee was advised that it must be posted in an area of the home accessible to parents. Title 22 102419.

Nutrition Requirement. Licensee was made aware of AB 290, commencing January 1, 2016, requiring at least one director or teacher at each child care center or family child care home to have at least one hour of training in the importance of childhood nutrition. This applies to anyone submitting a new application, relocating their facility, selling their facility or transferring their license. Please note this training cannot be completed online or by home study programs. The training must be taken from an Emergency Medical Services Authority (EMSA) approved training program OR an accredited college or university. Health & Safety Code 1596.8661.

Mandated Reporter Required. Licensee was made aware of AB 1207, commencing January 1, 2018, requires all licensed providers, Licensees, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Volunteers are encouraged but not required to take the training. Website: www.mandatedreporterca.com Health & Safety Code 1596.8662.
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SUPERVISOR'S NAME: Maureen Neal	TELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Lillian J Casillas	TELEPHONE: (424) 301-3097
LICENSING EVALUATOR SIGNATURE:	DATE: 07/29/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2021

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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: ZHOU FAMILY CHILD CARE	FACILITY NUMBER: 197494854
	VISIT DATE: 07/29/2021

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LPAs advised Licensee to follow and remain updated with COVID-19 guidelines.

Licensing Reports Given to Parents Required. Upon receipt by the licensee, licensees are to provide to parents/guardians the following: Copies of any licensing reports that document a Type A citation- this includes facility visits and substantiated complaint investigations; copy of licensing documents pertaining to a conference conducted by a local licensing agency management representative and the licensee of this family child care home in which issues of noncompliance are discussed or copies of a summary of an accusation indicating the Department's intent to revoke the facility's license. Copies of any of the above licensing documents the licensee has received in the prior 12 months shall be provided to parents/guardians of newly enrolled child at the facility. Assembly Bill 633.

Incidental Medical Services Awareness. 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, Website: www.ada.gov/childqanda.htm Facilities that provide Incidental Medical Services (IMS) must identify those services in their facility’s Plan of Operation and submit an updated Plan of Operation to the Department. Incidental Medical Services Include: Blood-Glucose Monitoring for Diabetic Children, Administering Inhaled Medication, Administering EpiPen Jr. and EpiPen or other Epinephrine Auto-Injectors, Glucagon Administration, Gastrostomy Tube Care (G-tube care), Insulin Injections Administration, Anti-Seizure Administration, and Emptying an Ileostomy Bag.

An exit interview was conducted with the Licensee on 7/29/2021 at 10:30 AM and a copy of this report (LIC809) was provided to the Licensee.

SUPERVISOR'S NAME: Maureen Neal	TELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Lillian J Casillas	TELEPHONE: (424) 301-3097
LICENSING EVALUATOR SIGNATURE:	DATE: 07/29/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2021

LIC809 (FAS) - (06/04)

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