198006988-12-12-2019-33-CC-JHUA-BJSN2S-20191212090514

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198006988
Report Date: 12/12/2019
Date Signed: 12/12/2019 09:05:20 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:	CHOI FAMILY CHILD CARE		FACILITY NUMBER:	198006988
ADMINISTRATOR:	CHOI, CHU		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(626) 839-3739
CITY:	ROWLAND HEIGHTS	STATE: CA	ZIP CODE:	91748
CAPACITY:	14	CENSUS: 3	DATE:	12/12/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:13 AM
MET WITH:	Chu Choi		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	Random inspection conducted by Licensing Program Analyst, Jennifer Hua. LPA met with licensee and her mom Leng Chu (assistant), Licensee guided LPA on a facility tour. Licensee speak primarily Cantonese and some English. The facility is a single story home. LPA observed children in care supervised by Licensee and assistant. Per licensee, total 3 adults residing in the home. Areas accessible to children were inspected as follows: bathroom, living room, and fenced backyard. Per licensee, there are no weapons, firearms, swimming pool or spa on the premises. There are age appropriate toys and equipment on the premises. The smoke/carbon monoxide detectors and fire extinguisher (2A 10BC) are in operable condition. Fire extinguisher was purchased on 11/21/19. Areas off limits include: 3 bedrooms, kitchen, garage, front yard. -Licensee and assistant have current Pediatric First Aid/CPR certificate which will expire on 10/19/21. -Child Care Roster, Disaster Plan, Children records and required licensing forms were discussed and provided as well as mandated child abuse reporting and criminal records clearance (finger prints and child abuse clearance) requirement. The following was discussed: Individuals who are 18 years of age or older living in the home must be finger print cleared prior to being on the premise. Individuals within one month of their 18th birthday must be fingerprinted immediately. Existing fine is an immediate $100 per day Civil Penalty, for a maximum of five days per person for the first violation and a maximum of 30 days for subsequent violations. If an individual has a clearance with the Department a criminal record clearance may be transferred. LIC 9182 Criminal Background Clearance Transfer Request may be used.

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 513-3793
LICENSING EVALUATOR NAME: Jennifer Hua	TELEPHONE: (323) 981-3375
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2019

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: CHOI FAMILY CHILD CARE	FACILITY NUMBER: 198006988
	VISIT DATE: 12/12/2019

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 and discussed with licensee. Child Care Liability Insurance policy observed. Drills conducted on 10/14/19. Licensee was informed that licensee and staff need to complete the Mandated Reporter Training on department website at http://www.mandatedreporterca.com/ when it is available in their 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: Ana Chico	TELEPHONE: (323) 513-3793
LICENSING EVALUATOR NAME: Jennifer Hua	TELEPHONE: (323) 981-3375
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2019

LIC809 (FAS) - (06/04)

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