198017249-11-13-2019-33-CC-JHUA-BHVQS7-20191113112504

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198017249
Report Date: 11/13/2019
Date Signed: 11/13/2019 11:25:15 AM

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:	LIANG FAMILY CHILD CARE		FACILITY NUMBER:	198017249
ADMINISTRATOR:	LIANG, ANNIE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(626) 758-7770
CITY:	SAN GABRIEL	STATE: CA	ZIP CODE:	91775
CAPACITY:	14	CENSUS: 6	DATE:	11/13/2019
TYPE OF VISIT:	Annual/Required	UNANNOUNCED	TIME BEGAN:	08:37 AM
MET WITH:	Annie Liang		TIME COMPLETED:	11:30 AM

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	Unannounced Required inspection conducted by Licensing Program Analyst (LPA) Jennifer Hua. LPA met licensee, Annie Liang. Upon arrival, LPA observed 1 child in care. Assistant Shaoxia Huang was also present. Licensee guided analyst on a tour of the facility. Licensee and assistants are Cantonese speaking. Visit was conducted in Cantonese. During the visit, 5 more children were being dropped off. Assistant Yanbing Li also arrived during visit. This is a one story home which consists of 3 bedrooms, 3 bathrooms, kitchen, living room, den/activity room and backyard (fenced). The children use the living room, den/activity room, dining room. The children use the restroom in the hallway. Per licensee, areas off limits to children and parents include: 1 bedroom and 2 bathrooms and far end of backyard . Licensee states that total 3 adults live in the home. No minors live in the home. All areas used by children were inspected. The following was observed during this visit. Detergents, cleaning compounds, medications, and other items which could pose a danger to children are inaccessible to children. Licensee states that there are no poisons in the home. Fireplaces and open face heaters are screened to prevent access by children. Fireplace is inaccessible and heating is central. The home was observed to have heating and ventilation for safety and comfort. The valve on the required 2A 10BC fire extinguisher indicates fully charged and extinguisher was serviced on 11/5/19 as noted on the tag. Smoke detectors in the den/activity room were tested, and observed to be working. Carbon monoxide detector is available and operational.. The home was observed to be clean and orderly.

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 513-3793
LICENSING EVALUATOR NAME: Jennifer Hua	TELEPHONE: (323) 981-3375
LICENSING EVALUATOR SIGNATURE:	DATE: 11/13/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2019

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: LIANG FAMILY CHILD CARE	FACILITY NUMBER: 198017249
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 11/13/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 11/20/2019 Section Cited	1 2 3 4 5 6 7	Immunizations. The licensee shall document each child's immunizations as required by the California Code of Regulations, Title 17, Section 6070, and shall maintain such documentation for as long as the child is enrolled. This requirement includes updating each child's PM 286 (6/95) when the child is due to receive required immunizations after
	8 9 10 11 12 13 14	enrollment in the family day care home. The requirement is not met as evidenced by. Child #1 lack record and child #2 needs updated record. This poses a potential risk to the health and safety of children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7
	1 2 3 4 5 6 7

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: Ana Chico	TELEPHONE: (323) 513-3793
LICENSING EVALUATOR NAME: Jennifer Hua	TELEPHONE: (323) 981-3375
LICENSING EVALUATOR SIGNATURE:	DATE: 11/13/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2019

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: LIANG FAMILY CHILD CARE	FACILITY NUMBER: 198017249
	VISIT DATE: 11/13/2019

NARRATIVE

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Staff and Children’s Records were reviewed for completeness; Inspection of required forms was made. A Child Care Provider's Guide to Safe Sleep handout was provided and discussed. LPA observed affidavit for liability insurance form in children's files. Licensee was informed to complete the Mandated Reporter Training on department website at http://www.mandatedreporterca.com/ if training is available in her language. Licensee completed the Mandated Reporter Training on 1/19/18 with the help of a translator. Certificate observed.

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

During this visit, LPA also obtain additional information regarding the incident that was reported on 6/4/19. Licensee and staff were interviewed.

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

Deficiency cited on attached 809D.

Exit interview was conducted with Annie Liang, licensee, including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role. Notice of Site Visit form was posted and explained. The notice shall be posted for 30 days or a civil penalty of $100 shall be assessed.

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SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 513-3793
LICENSING EVALUATOR NAME: Jennifer Hua	TELEPHONE: (323) 981-3375
LICENSING EVALUATOR SIGNATURE:	DATE: 11/13/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2019

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: LIANG FAMILY CHILD CARE	FACILITY NUMBER: 198017249
	VISIT DATE: 11/13/2019

NARRATIVE

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There are no stairs in the home.
There is a working telephone in the home.
Outdoor play area is fenced.
The capacity specified on the license shall be the maximum number of children for whom care can be provided. The licensee is operating within the license capacity limitations. LARGE FAMILY CHILD CARE HOME: The maximum number of children for whom care shall be provided when there is an assistant in the home, shall be either 12 children, no more than 4 of infants; up to 14 children, if conditions specified in regulations are met.
All homes shall conduct fire and disaster drills at least once every six months, and document the date and time of each drill. Last drills documented was on 10/15/19.
All individuals present in the home have obtained a criminal record clearance.
The licensee and assistant Yanbing Li are current in Pediatric First Aid and CPR that will expire on 01/12/21.

There was NO ZERO TOLERANCE deficiencies cited during this visit. Zero Tolerance includes:

Absence of Supervision.
Accessible Bodies of Water.
Accessible Firearms, Ammunition or Both.
Refused entry into a Facility or Any Part of a Facility in Violation of Section 1596.852, 1596.853 or 1597.09. Regulations 101238 (g)(2).
The Presence of an Excluded Individual.

The following items were also discussed with licensee during this visit.

There are no firearms, weapons, bodies of water or pets on the premises.
Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted
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.
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.

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 513-3793
LICENSING EVALUATOR NAME: Jennifer Hua	TELEPHONE: (323) 981-3375
LICENSING EVALUATOR SIGNATURE:	DATE: 11/13/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2019

LIC809 (FAS) - (06/04)

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