198017943-10-22-2019-33-CC-FVAZ-BH7N8E-20191022101412

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198017943
Report Date: 10/22/2019
Date Signed: 10/22/2019 10:14:22 AM

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:	YU FAMILY CHILD CARE		FACILITY NUMBER:	198017943
ADMINISTRATOR:	YU, GUIYUAN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(626) 248-0209
CITY:	ALHAMBRA	STATE: CA	ZIP CODE:	91801
CAPACITY:	14	CENSUS: 7	DATE:	10/22/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:25 AM
MET WITH:	Guiyan Yu		TIME COMPLETED:	10:30 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	Licensing Program Analysts Fabiola Vasquez and Ariel Cazares conducted an unannounced annual random site inspection to ensure the health & safety standards as required by regulations governing family child care homes. Upon arrival, LPAs met with Licensee Guiyuan Yu who guided LPAs on a tour the facility. This is a single story home, 2 bedrooms, 1 bathroom, living room and kitchen. There were 5 children (2 infants, 3 Toddlers ) present but no assistant. Licensee did not speak English, but Licensee's son arrived shortly after and assisted with translation. The son has criminal record background clearance and immunization's are up to date. Licensee’s operating hours are Monday-Friday, 8am-6pm. Areas accessible to children were inspected as follows: Living room, bathroom, 2 bedrooms and kitchen. Areas off limits include: Front yard Licensee states that there are no weapons or firearms on the premises. LPA did not observe swimming pools or spas on the premises. There are age appropriate toys and equipment on the premises. The smoke detectors and carbon monoxide detectors are present in the facility and operational. Fire extinguisher was last purchased on 6/12/18, but has not been serviced. LPAs observed bumpers on the cribs in the home. LPAs advised licensee that bumpers are not permitted and informed her of new safe sleep guidelines. CPR Card valid until: 2/24/2018, Roster was not available for review. LPA provided LIC 9040-Children's Roster to Licensee. Children's Records were reviewed and found complete. Mandated child abuse reporting is not available in Licensees language. Page 1 of 3

SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3439
LICENSING EVALUATOR NAME: Fabiola Vasquez	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 10/22/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2019

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: YU FAMILY CHILD CARE	FACILITY NUMBER: 198017943
	VISIT DATE: 10/22/2019

NARRATIVE

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Licensee does not provide this service at this time. 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

All adults living and working in the home shall be made of aware of the Departments right to inspection authority, which includes but not limited to the right to enter the home when children are being cared for, interview children and adults and review documentation.

Forms and updates can be found on the Department website: www.ccld.ca.gov

There were deficiencies observed and cited during today's visit in accordance to the California Code of Regulations Title 22, Division 12, Chapter 1

Exit interview was conducted with Licensee Guiyan Yu. A copy of this report and appeal rights were given.

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.

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SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3439
LICENSING EVALUATOR NAME: Fabiola Vasquez	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 10/22/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2019

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: YU FAMILY CHILD CARE	FACILITY NUMBER: 198017943
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/22/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 10/29/2019 Section Cited	1 2 3 4 5 6 7	Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841. This is requirement has not been met as evidenced by licensee not having a roster available for review. This poses a potential risk to the health and safety of children in care.
Type B 10/29/2019 Section Cited	1 2 3 4 5 6 7	The licensee shall document the drills, including the date and time of each drill. This documentation shall be kept at the family child care home. This is requirement has not been met as evidenced by not having last drill conducted documented. This poses a potential risk to the health and safety of children in care.
Type B 10/29/2019 Section Cited	1 2 3 4 5 6 7	The home shall contain a fire extinguisher and smoke detector device which meet standards established by the State Fire Marshal. This is requirement has not been met as evidenced by review of fire extinguisher showing not serviced since purchased 6/12/18 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: Brandi VanOosten	TELEPHONE: (323) 981-3439
LICENSING EVALUATOR NAME: Fabiola Vasquez	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 10/22/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2019

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: YU FAMILY CHILD CARE	FACILITY NUMBER: 198017943
	VISIT DATE: 10/22/2019

NARRATIVE

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The following was discussed with the Licensee:

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.

In the absence of the Licensee, a qualified adult must be present supervising the children; a qualified adult is an individual who has a valid and current adult/infant CPR & Pediatric First Aid certification and a valid criminal record clearance associated to the facility license.

A current roster of children enrolled must be available and maintained for a period of three years, even after children no longer are attending the facility. Annual fees must be paid promptly and by the due date or a late fee shall be assessed and/or the License shall be terminated.

The fire extinguisher type 2A-10BC must be serviced annually or as often as necessary. Smoke and Carbon Monoxide detectors should be checked, and batteries replaced as needed. Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your home.

Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing. Fire and safety drills must be performed every six months and documented for review by the Department. Smoking is prohibited in a family child care home. Children and Staff records must be maintained and updated as needed and must be available for review by the Department.

Baby walkers, saucer chairs, bouncers or any similar items are prohibited. Sudden Infant Death Syndrome (SIDS) and Never-Shake-a-Baby were discussed. LPA provided licensee with safe sleep resources.

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SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3439
LICENSING EVALUATOR NAME: Fabiola Vasquez	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 10/22/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2019

LIC809 (FAS) - (06/04)

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