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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198016296
Report Date: 04/05/2022
Date Signed: 04/05/2022 01:38:14 PM


Document Has Been Signed on 04/05/2022 01:38 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:WONG FAMILY CHILD CAREFACILITY NUMBER:
198016296
ADMINISTRATOR:WONG, SHELLYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 285-8730
CITY:ALHAMBRASTATE: CAZIP CODE:
91801
CAPACITY:14CENSUS: 10DATE:
04/05/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:50 AM
MET WITH:Shelly Wong TIME COMPLETED:
01:55 PM
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Licensing Program Analysts, Seung Lee 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 02/2023, Licensee's disaster drill log notes last drill conducted on 4/1/22. Licensee has a working telephone. Children's files and roster were reviewed.

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: Guangorena ClaudiaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Seung LeeTELEPHONE: (323) 981-3382
LICENSING EVALUATOR SIGNATURE:
DATE: 04/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/05/2022
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: WONG FAMILY CHILD CARE
FACILITY NUMBER: 198016296
VISIT DATE: 04/05/2022
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LPA observed the carbon and smoke detectors in the home and found them to be operational. The fire extinguisher, located in the dining room was purchased on 03/12/22. There are no firearms present on the premises as stated by licensee. 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.

· 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
SUPERVISOR'S NAME: Guangorena ClaudiaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Seung LeeTELEPHONE: (323) 981-3382
LICENSING EVALUATOR SIGNATURE:

DATE: 04/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2022
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: 04/05/2022
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LPA advised the Licensee to access forms and regulations on line at: www.ccld.ca.gov

Licensee was advised to continue to comply with the latest guidelines for family child care homes from the CA department of Health

No Deficiencies were cited during the inspection

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: Guangorena ClaudiaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Seung LeeTELEPHONE: (323) 981-3382
LICENSING EVALUATOR SIGNATURE:

DATE: 04/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2022
LIC809 (FAS) - (06/04)
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