198009202-6-11-2021-33-CC-FVAZ-C3VSZL-20210611141918

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198009202
Report Date: 06/11/2021
Date Signed: 06/11/2021 02:19:51 PM

COMPREHENSIVE INSPECTION

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: 3	DATE:	06/11/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Wen Xiu Yang		TIME COMPLETED:	02:30 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 (LPA) Fabiola Vasquez contacted the facility via telephone due to COVID-19 and precautionary measures LPA conducted the screening procedures and received the clearance to go into facility at 11:30. LPA conducted an unannounced random inspection. LPA met with licensee, Wen Xiu Yang and S1 who translated and guided analyst on a tour of the facility. Present were licensee and S1 and 3 children, 1 being licensee grandchild. Licensee states that there are currently 7 children enrolled. Days and hours of operation are: Monday to Saturday from 08:00 AM. to 06:00 PM. Individuals residing in the home are 2 adults and no children. The Licensee is within the conditions, limitations, and capacity specified on the license. The children's roster was reviewed and is current. Family members residing in the home are 2 adults (criminal record clearances on file) and 0 children. There are no pets. This is a one-story home which consists of 4 bedrooms, 3 bathrooms, 2 kitchen, den, dining room, living room, detached garage, front yard, back yard and three individual units in the back side of the house. Per licensee no one resides in the units. Sometimes the licensee has visitors that come and stay for a few days. Are finger print cleared and associated to the facility. Fire place is barricaded in an inaccessible room to children. Areas accessible to children were inspected as follows: Living room, restroom located in the hallway. Areas off limits include: 4 bedrooms, 2 bathrooms, 2 kitchen, den, dining room, detached garage, front yard, back yard and three individual units in the back side of the house. PAGE 1 OF 5

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Fabiola Vasquez	TELEPHONE: (626) 361-1267
LICENSING EVALUATOR SIGNATURE:	DATE: 06/11/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2021

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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: YANG FAMILY CHILD CARE	FACILITY NUMBER: 198009202
	VISIT DATE: 06/11/2021

NARRATIVE

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Areas accessible to children were inspected to ensure that they are clean and orderly with central ventilation and heating, wall heater was not observed, all areas were inspected for safety and comfort. There were safe toys, play equipment and materials observed for children. LPA did not observe stairs. There is a working telephone service maintained in the home. Detergents, cleaning compounds, medications, and other items which can pose a danger to children are inaccessible stored in the kitchen and up high, licensee states that there are no poisons in the home. The licensee does understand that poison must be locked with a key or combination lock.

There are safe toys, play equipment and materials observed for children.

Per licensee, there are no infant in care, LPA observed 2 cribs and inspected sleeping equipment for infants. who is unable to climb out of the crib. All equipment meets the US Consumer Product Safety Commission safety standards. LPA observed that cribs are free from loose articles or objects hanging above or attached to the side of the crib. There are no objects hanging above or attached to the side of the crib. LPA observed that cribs do not hinder the entrance or exit to and from the space they are sleeping in. Mattresses were observed to be firm and covered with a fitted sheet that is appropriate to the mattress size. Each infant has their individual bedding and is washed weekly as required. Soiled bedding is replaced when wet or soiled and is placed in an area inaccessible to infants. Pacifiers and bumper were not observed. Licensee was advised that infants shall not be swaddled while in care and all infants up to 12 months should be placed on their back for sleeping.

Per licensee she is not caring for infants, LPA discussed and reviewed the following,
LIC 9227 (Individual Sleeping Plan) for infants up to 12 months was explained along with PIN 20-24-CCP was issued to the Licensee. Title 22 Regulation Section 102425(j) Infant Safe Sleep was discussed with the Licensee, including but not limited to documentation that shall be maintained.

Rooms that are off-limits need to be made inaccessible during operating hours. No smoking, No infant walkers, No Johnny jumpers, No saucer chairs, No trampolines and any other item that falls into that category are not permitted in the facility. Car seats shall only be used for transportation purposes and shall not be used for sleeping.

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SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Fabiola Vasquez	TELEPHONE: (626) 361-1267
LICENSING EVALUATOR SIGNATURE:	DATE: 06/11/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2021

LIC809 (FAS) - (06/04)

Page: 2 of 5

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: 06/11/2021

NARRATIVE

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Per licensee, there are no weapons, firearms or bodies of water on the premises. Children’s records were reviewed to ensure that each child has an Identification and Emergency form. The valve on the required 2A 10BC fire extinguisher indicates fully charged (purchased 09/25/20 receipt attached). Smoke detector and carbon monoxide detector in the dining room were tested, and are in operable condition. The licensee has current Pediatric First Aid and CPR, which will expire 02/2022.

Proof of immunization against influenza, pertussis, and measles for the Licensee and Assistants was readily available during today’s inspection.
License has not taken the mandated reporter due to training not being available in their primary language.

Per licensee, does not provide IMS,
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

SB792 (Immunization Requirements for Staff and Employees) was reviewed and discussed with the Licensee. The Licensee and her assistants do not currently have immunization documentation.
AB1207 Mandated Child Abuse Reporting – was reviewed and discussed, on or before March 30, 2018 any person who works in a child care facility shall complete the training and renew the training every 2 years. Website provided: https://www.mandatedreporterca.com/training/child-care-providers Licensee completed training on .

The following was discussed:
· Individuals who are 18 years of age or older living in the home must obtain a criminal record clearance. Individuals within one month of their 18th birthday must be fingerprinted immediately. Failure to obtain a criminal record background check clearances prior to initial presence in the home will result in an immediate $100.00 dollar or more per day Civil Penalty.
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SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Fabiola Vasquez	TELEPHONE: (626) 361-1267
LICENSING EVALUATOR SIGNATURE:	DATE: 06/11/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2021

LIC809 (FAS) - (06/04)

Page: 3 of 5

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: 06/11/2021

NARRATIVE

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· The Licensee shall be present in the home and shall ensure that children are supervised at all times.
· Children shall not be left in park vehicles.
· The capacity specified on the license shall be the maximum number of children for whom care can be provided.
· Car seats shall only be used for transportation purposes and shall not be used for sleeping.
· All children in care have the right to receive safe, healthful, and comfortable accommodations, furnishings and equipment.
· When a child shows signs off illness, they will be separated from other children until the nature if the illness is determined.
· Effective January 1, 2010, licensees of family child care homes are required to ensure that at least one staff member with current training in pediatric first aid and pediatric CPR is on site at all times when children are present.

LPA reviewed and issued the LIC 311 - Forms/Records to Keep in Your Family Child Care Home.
CHILDREN’S FORMS/RECORDS, FACILITY FORMS/RECORDS and INFORMATION TO BE POSTED, Disaster drills ( 06/16) posting requirements, children records requirements, mandated child abuse and injury/death reporting, and criminal record transfer requirements were discussed.

LPA provided a Safe Sleep Awareness Campaign (PIN) 19-02-CCP dated February 20, 2019 packet, Never Shake a Baby (Pub 271), A Child Care Providers Guide to Safe Sleep (SIDS) American Academy of Pediatrics and California Child Passenger Safety Law during today’s inspection. PIN 21-02-CCLD Updates to the implementations of guardian.

Copies of LIC 610 Emergency Disaster Plan.

The licensee’s email address was obtained during this visit. The licensee was advised that email is public information.

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SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Fabiola Vasquez	TELEPHONE: (626) 361-1267
LICENSING EVALUATOR SIGNATURE:	DATE: 06/11/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2021

LIC809 (FAS) - (06/04)

Page: 4 of 5

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: 06/11/2021

NARRATIVE

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LPA advised the licensee how to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov

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.

A Technical Assistance was provided.

At this time, the licensee is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued today.

Exit interview was conducted with Licensee, . The Licensee, Wen Xiu Yang and S1 was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these forms.

CHILDREN FILES REVIEW – Child's ID and Emergency information, Immunization. Consent for medication on file.

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SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Fabiola Vasquez	TELEPHONE: (626) 361-1267
LICENSING EVALUATOR SIGNATURE:	DATE: 06/11/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2021

LIC809 (FAS) - (06/04)

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