198009202-8-20-2019-33-CC-AALN-BF8SCS-20190820134602

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198009202
Report Date: 08/20/2019
Date Signed: 08/20/2019 01:46:07 PM

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:	YANG FAMILY CHILD CARE		FACILITY NUMBER:	198009202
ADMINISTRATOR:	WEN XIU YANG		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(626) 286-5566
CITY:	TEMPLE CITY	STATE: CA	ZIP CODE:	91780
CAPACITY:	14	CENSUS: 4	DATE:	08/20/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Wen Xiu Yang		TIME COMPLETED:	02:00 PM

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

Licensing Program Analyst, Ariel Cazares conducted an unannounced annual random site inspection to the licensed home. Upon arrival, LPA met with Licensee Wen Xiu Yang. LPA spoke to licensee's daughter on the phone to translate reason for visit. LPA toured the facility. There were 4 children present. Licensee's assistant/niece(neice) Ying Chang arrived shortly after and assisted with translation. Also present were the assistant's parents who live in the home. Individuals residing in the home are the licensee, spouse, daughter, licensee's niece and her parents, 2 minor children. Licensee’s operating hours are Monday-Friday 8am-6pm.

The home is a one story, 4-Bed, 3-Bath home. The following areas are used for day-care: Living Room, 1 bathroom. Off limit areas include: 3 bedrooms, 3 bathrooms, kitchen, frontyard and backyard, and detached garage.

Licensee has the required postings located at the entrance of the home. Licensee's First Aid/CPR certificate are valid through 03/2020. Licensee's disaster drill log notes last drill conducted on 2/14/19 and is due for another this month. Licensee has a working telephone. LPA reviewed children's roster and files. Licensee has her immunizations on file for both herself and her assistant.

LPA inspected the areas used by daycare children. The living room is used as their main activity/napping space. LPA observed appropriate equipment and toys for children. The restroom nearest the living room is used for children and there is a potty chair available for younger children. The fire extinguisher was purchased on 7/27/19. LPA tested the smoke detector and carbon monoxide in the kitchen, and found them to be both operational. Per licensee, there are no firearms present on the premises as stated by licensee. The backyard is kept off limits and there are no pools or spas, or other bodies of water. Currently there are no pets.

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Ariel Almazan	TELEPHONE: (323) 981-2949
LICENSING EVALUATOR SIGNATURE:	DATE: 08/20/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2019

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 2

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: YANG FAMILY CHILD CARE	FACILITY NUMBER: 198009202
	VISIT DATE: 08/20/2019

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
26
27
28
29
30
31
32

Reminders: Individuals who are 18 years of age or older living in the home must be finger print cleared prior to being in the presence of the children in care. Individuals within one month of their 18th birthday must be fingerprinted immediately. No smoking, No infant walkers, No baby bouncers, No Johnny jumpers, No exersaucers and any other item that falls into that category. LPA discussed disaster drills, posting requirements, children records requirements, mandated child abuse and injury/death reporting.

· LPA reviewed SIDs, Never Shake A Baby, and safe sleeping practices. Infants should sleep mouth up, on their backs, free of clutter surrounding their sleeping space. A copy of Safe Sleep concepts were provided.
· 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, available at: http://www.ada.gov/childqanda.htm
· A qualified Assistant must be present and actively involved in caring for children whenever nine (9) or more children are present at the facility in a large family child care home.
· LPA advised the Licensee to access forms and regulations on line at: www.ccld.ca.gov
· Mandated reporter training must be completed every 2 years. www.mandatedreporterca.com
*Currently not available in the licensee's primary language, licensee is exempt.

No Deficiencies were cited on this visit.

Exit interview was conducted with Licensee Wen Xiu Yang. A copy of this report was provided and explained. The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Ariel Almazan	TELEPHONE: (323) 981-2949
LICENSING EVALUATOR SIGNATURE:	DATE: 08/20/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2019

LIC809 (FAS) - (06/04)

Page: 2 of 2