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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198007208
Report Date: 08/09/2023
Date Signed: 08/09/2023 01:04:22 PM


Document Has Been Signed on 08/09/2023 01:04 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754



FACILITY NAME:HUNG FAMILY CHILD CAREFACILITY NUMBER:
198007208
ADMINISTRATOR:HUNG, TSAI-LIENFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(909) 594-2873
CITY:WALNUTSTATE: CAZIP CODE:
91789
CAPACITY:14CENSUS: 3DATE:
08/09/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
12:37 PM
MET WITH:Tsai-Lien HungTIME COMPLETED:
01:05 PM
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Plan of correction inspection conducted by Licensing Program Analyst (LPA) Jennifer Hua. LPA was greeted by Licensee. The purpose of the visit was announced. Covid-19 risk assessment was conducted. The purpose of the visit is to follow up on the deficiencies cited on 7/27/2023. LPA observed 3 children in care. Licensee stated, currently there are 4 children enrolled. 1 child did not come today.

Based on observation:

Staffing Ratio and Capacity - Corrected at this time
Operation of a Family Child Care Home - Documents received via email.

Based on above, no deficiency cited today.

An exit interview conducted with licensee. Copy of report provided. Notice of Site Visit form provide and shall be posted in an area accessible for review.
SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Jennifer HuaTELEPHONE: (323) 981-3375
LICENSING EVALUATOR SIGNATURE:
DATE: 08/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/09/2023
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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