198016972-9-11-2019-33-CC-JHUA-BFWREE-20190911125727

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198016972
Report Date: 09/11/2019
Date Signed: 09/11/2019 12:57:33 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:	ZHANG FAMILY CHILD CARE		FACILITY NUMBER:	198016972
ADMINISTRATOR:	ZHANG, LI JUAN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(626) 458-1859
CITY:	ALHAMBRA	STATE: CA	ZIP CODE:	91803
CAPACITY:	14	CENSUS: 9	DATE:	09/11/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:55 AM
MET WITH:	Li Juan Zhang		TIME COMPLETED:	01:05 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	Random site inspection conducted by Licensing Program Analyst, Jennifer Hua. LPA met with licensee and her spouse, Licensee guided the analyst on a tour of the facility. Licensee speaks primarily Cantonese and Mandarin. This is a single story home, with 4 bedroom and 2 bathroom. Per licensee, there are 6 adults and 0 minor. Areas accessible to children were inspected as follows: living room, first bedroom, 2 bathrooms, and fenced side yard (driveway). Per Licensee, there are no weapons/firearms in the home. There is no swimming pool or bodies of water on the premise at this time. The backyard is adequately fenced. There are age appropriate toys and equipment on the premises. The smoke/carbon monoxide detector is in operable condition and fire extinguisher (2A 10BC) is fully charged and was serviced 7/10/2018. Licensee will have it serviced immediately. Areas off limits include: 3 bedrooms, backroom (den). and backyard and front yard and detached structure. -Licensee is current in Pediatric CPR/First Aid. Certificate will expire on 2/24/20. -Child Care Roster, Disaster Plan, and Children's Records were reviewed. -Children records and required licensing forms were discussed as well as mandated child abuse reporting and criminal records clearance (finger prints and child abuse clearance) requirement. The following was discussed: Individuals who are 18 years of age or older living/working in the home must be finger print cleared prior to living or working in the home. Individuals within one month of their 18th birthday must be fingerprinted immediately. If an individual has a clearance with the Department a criminal record clearance may be transferred. LIC 9182 Criminal Background Clearance Transfer Request may be used.

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 513-3793
LICENSING EVALUATOR NAME: Jennifer Hua	TELEPHONE: (323) 981-3375
LICENSING EVALUATOR SIGNATURE:	DATE: 09/11/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2019

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: ZHANG FAMILY CHILD CARE	FACILITY NUMBER: 198016972
	VISIT DATE: 09/11/2019

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

Rooms that are off-limits need to be made inaccessible during operating hours. No smoking, No infant walkers, Johnny jumpers, exersaucers, bouncers and any other item that falls into that category, earthquake – fire, disaster drills and safety, posting requirements, children records requirements, mandated child abuse and injury/ death reporting, criminal records, child abuse clearance and criminal records transfer requirements, SIDS, Never Shake A Baby, Drills conducted on 5/16/19. A Child Care Provider's Guide to Safe Sleep was provided to licensee. Children currently enrolled are age 1 and older. Child Care Liability insurance policy in place.

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) 514-0388 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

· Dog(s) and or pets should be isolated from children in care. No pets observed.
· It is recommended that a First Aid kit be available on premises.
Outdoor supervision required at all times. If outdoor area not adequately fenced provider must be with children at all times when outdoors.

No deficiencies cited during this visit.

Exit interview was conducted with licensee.

Notice of Site Visit notice posted. And Licensee advised to keep notice posted for 30 day or a civil penalty of $100 will be assessed..

Web site address to order forms: http://www.dss.cahwnet.gov/cdssweb/On-lineFor_293.htm#l
INTERNET ADDRESS: http://www.ccld.ca.gov – To access licensing forms, updates and Title 22.

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 513-3793
LICENSING EVALUATOR NAME: Jennifer Hua	TELEPHONE: (323) 981-3375
LICENSING EVALUATOR SIGNATURE:	DATE: 09/11/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2019

LIC809 (FAS) - (06/04)

Page: 2 of 2