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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198016296
Report Date: 08/06/2019
Date Signed: 08/06/2019 12:06:30 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:WONG FAMILY CHILD CAREFACILITY NUMBER:
198016296
ADMINISTRATOR:WONG, SHELLYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 285-8730
CITY:ALHAMBRASTATE: CAZIP CODE:
91801
CAPACITY:14CENSUS: 10DATE:
08/06/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Shelly WongTIME COMPLETED:
12:20 PM
NARRATIVE
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Licensing Program Analysts, Ariel Cazares and Fabiola Vasquez conducted an unannounced annual random inspection to the licensed home. Upon arrival, LPA met with Licensee Shelly Wong and toured the facility. There were 10 children present, along with 2 assistants. Individuals residing in the home are the licensee, spouse, mother, and two adult children. Licensee’s operating hours are Sunday- Saturday, 7am-10pm.

The home is a one story, 4-Bed, 3-Bath home. The following areas are used for day-care: Living room, play/nap room, dining room, kitchen, 1 bedroom (for napping infants), 1 restroom, and backyard. Off limit areas include: Section of the home where bedrooms and remaining restrooms are located. Only one bedroom is used for napping infants which licensee escorts them to. Off limits areas have safety gates.

Licensee has the required postings in the living room on the wall. Licensee's First Aid/CPR certificate are valid through 03/2021, Licensee's disaster drill log notes last drill conducted on 4/9/19. Licensee has a working telephone. Children's files and roster were reviewed. Staff files were reviewed. Licensee is missing proof of pertussis vaccine or exemption. Licensee's mother did not have any immunization records. Licensee completed mandated reporter training on 3/8/18.

LPAs inspected all areas used by the daycare children. LPA observed appropriate toys, games, and books for children. Children's restroom was free of hazards and in clean condition. The kitchen has latches on cabinets that store knives and cleaning compounds.

SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Ariel AlmazanTELEPHONE: (323) 981-2949
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2019
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 4
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: WONG FAMILY CHILD CARE
FACILITY NUMBER: 198016296
VISIT DATE: 08/06/2019
NARRATIVE
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· 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

Deficiencies were cited in accordance with California Code of Regulations Title 22. See 809-D.

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.

Exit interview was conducted with Licensee Shelly Wong. A copy of this report and appeal rights were provided and explained.
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Ariel AlmazanTELEPHONE: (323) 981-2949
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2019
LIC809 (FAS) - (06/04)
Page: 4 of 4
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: WONG FAMILY CHILD CARE
FACILITY NUMBER: 198016296
VISIT DATE: 08/06/2019
NARRATIVE
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LPAs tested the carbon and smoke detectors in the home and found them to be operational. The fire extinguisher, located in the dining room was serviced on 2/8/19. There are no firearms present on the premises as stated by licensee. The backyard where children play was inspected. LPA observed 4 tall water bins with tight fitting lids filled with collected rain water. LPA informed licensee to make them off limits using a barrier or removing them to an off-limits area of the backyard. There are no other pools or spas, or other bodies of water. There are two dogs..

The following were discussed: 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 LIC 311D with licensee, reminding her of required forms. 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. 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.
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Ariel AlmazanTELEPHONE: (323) 981-2949
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2019
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: WONG FAMILY CHILD CARE
FACILITY NUMBER: 198016296
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/06/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/13/2019
Section Cited
CCR
102417(g)(5)
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All licensees shall ensure the inaccessibility of pools (in-ground and above-ground), fixed-in-place wading pools, hot tubs, spas, fish ponds and similar bodies of water through a pool cover or by surrounding the pool with a fence.

This requirement has not been met as
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Per licensee, she will provide LPA with a photo of how she corrected and made bins inaccessible by POC due date of 8/13/19.
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evidenced by LPAs observations of 4 tall water bins filled with water in the backyard where children play. Bins did have lids but were not made inaccessible.

This poses a potential risk to the health and safety of children in care.
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Type B
08/20/2019
Section Cited
HSC
1597.622(c)
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The family day care home shall maintain documentation of the required immunizations or exemptions from immunization, as set forth in this section, in the person’s personnel record that is maintained by the family day care home.

This requirement has not been met as
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Per licensee, she will obtain the missing records for herself and her mother and submit a copy to LPA by POC due date of 8/20/19.
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evidenced by LPAs review of staff immunization records. Licensee and her mother did not have complete records.

This poses a potential risk to the health and safety of children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Ariel AlmazanTELEPHONE: (323) 981-2949
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2019
LIC809 (FAS) - (06/04)
Page: 3 of 4