198003142-4-5-2024-33-CC-NTCG-D42UEB-20240405153051

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198003142
Report Date: 04/05/2024
Date Signed: 04/05/2024 03:31:01 PM

Document Has Been Signed on 04/05/2024 03:31 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	SHI AND LIU FAMILY CHILD CARE		FACILITY NUMBER:	198003142
ADMINISTRATOR:	SHI, YIN JIAO; LIU, JIAN F		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(626) 288-6972
CITY:	ROSEMEAD	STATE: CA	ZIP CODE:	91770
CAPACITY:	14	CENSUS: 3	DATE:	04/05/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	01:50 PM
MET WITH:	Yin Jiao Shi - Licensee		TIME COMPLETED:	03:45 PM

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Licensing Program Analysts (LPAs) Nolan Tcheng and Jessica Hopkins-Hernandez conducted an unannounced annual random inspection to the above facility. At 1:50pm, LPA met with licensee Yin Jiao Shi. Also present during this inspection was co-licensee Jian Feng. The licensee states that they currently has 4children enrolled. A current children’s roster is available and is current. Licensee’s hours of operation are 8am-6pm, Monday-Friday.

This is a two-story home which consists of 5 bedrooms, 4 bathrooms, kitchen, play area, living room, front yard and backyard (fenced). The children use bottom floor bedrooms (2), down stairs bathroom (2), play area, and backyard. Per licensee, areas off limits to children and parents include: the entire upstairs. Where children are less than five years old are in care, stairs are fenced or barricaded. There is a child safety gate which keeps stairs inaccessible to children. All areas identified on the facility sketch were inspected. The licensee provides food for children in care.

The licensee states that 2 adults and 0 minors currently live in the home. Persons living in home are identified on attached LIC811. Licensee states that they currently have one assistant. All individuals present in the home have obtained a criminal record clearance or exemption prior to working, residing or volunteering in a licensed home. Per licensee, there are no weapons, firearms or bodies of water on the premises.

At 2pm, LPAs were led on a tour of the facility by the licensee. The entrance to the home was down the driveway at a double door to the back part of the 3361 address. The front part of house is occupied by residents of the address but it is separated from the day care and has it's own entrance. The children enter from the back side of the house. Upon entry into the back part of the house, the child care area was reviewed. There are age appropriate equipment and toys for children in care to use. There is a safety gate that makes the kitchen inaccessible to children in care. To the left, one of the bedrooms was reviewed which is set up as a child care classroom with additional age appropriate equipment and toys. There were 3 children playing during the tour. REPORT CONTINUES PAGE 1 of 3

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) -98-3391
LICENSING EVALUATOR NAME: Nolan Tcheng	TELEPHONE: (323) 240-6201
LICENSING EVALUATOR SIGNATURE:	DATE: 04/05/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: SHI AND LIU FAMILY CHILD CARE	FACILITY NUMBER: 198003142
	VISIT DATE: 04/05/2024

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Smoke and carbon monoxide detectors were tested and are operable. The tour continued to the hallway where there was a cubbies and materials for children. Emergency Disaster Plan, Parent’s Rights Poster and the Facility License are observed to be posted. There are first aid supplies available. In the hallway, the bathroom for children in care was observed. Detergents, cleaning compounds, medications, and other items which could pose a danger are inaccessible to children. The last room at the end of the hall is a bedroom/office also used for children care. Per licensee, the bedroom will be used as an area for an ill child until an authorized representative comes to pick up child. Advisory Note was provided.

At 2:15pm, a fire extinguisher was observed. The valve on the required 2A 10BC fire extinguisher indicates fully charged and was serviced on 06/16/2022, as indicated on service tag. Per State Fire Marshall standards, fire extinguishers shall be serviced annually. LPA discussed the importance of replacing the fire extinguisher or having it serviced each year.

LPA observed napping equipment in the form of mats, cots, and cribs. Equipment is stored in the bedroom.The licensee states that there are no poisons in the home and understands that storage areas for poisons must be locked with a key or combination lock. Licensee states they have both a landline and a cell phone used for the facility.

At LPAs observed the back yard area. The outdoor play area was observed to be fenced. At this time, children are using the back yard for outdoor play time. LPA observed bikes, slides, and age appropriate toys.. The licensee is observed to be operating within the license capacity limitations.

The licensee and other personnel have completed training on preventive health practices including Pediatric First Aid and CPR. The licensee's Pediatric First Aid and CPR expires on 01/2025. Licensees both have completed mandated reporter training that expires on 10/04/2024. The licensee does have proof of immunization against influenza, tuberculosis, pertussis, and measles. Children’s records were reviewed, including but not limited to, a copy of the emergency information card that contains all the information speciﬁed by regulation.

The following was discussed:

-There are no pets on the premises.
-Infant Walkers, Johnny Jumpers, Saucer Chairs, and/or any other item that falls into these categories are not permitted in a family child care facility.
-Smoking is prohibited in a license family child care home.
REPORT CONTINUES PAGE 2 of 3

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) -98-3391
LICENSING EVALUATOR NAME: Nolan Tcheng	TELEPHONE: (323) 240-6201
LICENSING EVALUATOR SIGNATURE:	DATE: 04/05/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2024

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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: SHI AND LIU FAMILY CHILD CARE	FACILITY NUMBER: 198003142
	VISIT DATE: 04/05/2024

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Licensee was reminded that all adults 18 and over living or working in the home, 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

Licensee is caring for infants. LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee [or facility representative] 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.

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)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

Licensee [or facility representative] was informed of the MyChildCarePlan.org website; 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.

During the exit interview, the Licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee Yin Jiao Shi, at 3:30pm. Copy of report provided.

END OF REPORT PAGE 3 of 3

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) -98-3391
LICENSING EVALUATOR NAME: Nolan Tcheng	TELEPHONE: (323) 240-6201
LICENSING EVALUATOR SIGNATURE:	DATE: 04/05/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2024

LIC809 (FAS) - (06/04)

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