198018431-1-14-2020-33-CC-CGUA-BN3UAU-20200326152519

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198018431
Report Date: 01/14/2020
Date Signed: 01/14/2020 02:59:27 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/10/2020 and conducted by Evaluator Cynthia Reyes

PUBLIC

COMPLAINT CONTROL NUMBER: 33-CC-20200110140254

FACILITY NAME:	CAO & CHIANG FAMILY CHILD CARE		FACILITY NUMBER:	198018431
ADMINISTRATOR:	CAO,LING YAN & CHIANG,BOB		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(626) 513-0168
CITY:	ARCADIA	STATE: CA	ZIP CODE:	91007
CAPACITY:	14	CENSUS: 8	DATE:	01/14/2020
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Yan Ling Cao & Bob Chiang		TIME COMPLETED:	03:15 PM

ALLEGATION(S):

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Food Service

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPA) Cynthia Reyes, arrived unannounced at the facility for the purpose of conducting a complaint inspection regarding the allegation listed above. LPA met with Yan Ling Cao & Bob Chiang.

Complaint states that the facility does not give the children milk or if they do it is expired and the facility gives the children food that is not part of the food program list of proper meals. Per LPA interviews, own observation, and documents reviewed and received it was determined the complaint is unsubstantiated. Complainant states those issues occurred a few years ago and per LPA own observation children were given Non expired milk on this date as part of their lunch and LPA was given a copy of the menu they provide to the food program for this month. LPA did observe different food in the refrigerator and freezer that are not allowed and licensee stated that it is her families own food and not for the day care. Licensee states has never given expired milk or unhealty food. LPA consulted and advised the licensee to separate and identify the food for the day care children from her families own food.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 01/14/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2020

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 1 of 5

Control Number 33-CC-20200110140254

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: CAO & CHIANG FAMILY CHILD CARE	FACILITY NUMBER: 198018431
	VISIT DATE: 01/14/2020

NARRATIVE

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Although the above allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore at this time the above allegation is Unsubstantiated. Due to conflicting information received, LPA is unable to determine if the above allegation is valid.

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 conducted with the Licensee, during which appeal rights were given and explained. A copy of the Appeal Rights (LIC 9058 01/16) was provided. The Licensee’s signature on this report acknowledges receipt of rights.

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 01/14/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2020

LIC9099 (FAS) - (06/04)

Page: 2 of 5

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/10/2020 and conducted by Evaluator Cynthia Reyes

PUBLIC

COMPLAINT CONTROL NUMBER: 33-CC-20200110140254

FACILITY NAME:	CAO & CHIANG FAMILY CHILD CARE		FACILITY NUMBER:	198018431
ADMINISTRATOR:	CAO,LING YAN & CHIANG,BOB		FACILITY TYPE:	810
ADDRESS:	9408 E. DUARTE RD.		TELEPHONE:	(626) 513-0168
CITY:	ARCADIA	STATE: CA	ZIP CODE:	91007
CAPACITY:	14	CENSUS: 8	DATE:	01/14/2020
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Yan Ling Cao & Bob Chiang		TIME COMPLETED:	03:15 PM

ALLEGATION(S):

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Physical Plant.

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPA) Cynthia Reyes, arrived unannounced at the facility for the purpose of conducting a complaint inspection regarding the allegation listed above. LPA met with Yan Ling Cao & Bob Chiang.

Based on LPA Interviews and own observations, the preponderance of evidence standard has been met, therefore the above allegation of Physical Plant. Complaint states the facility is unsanitary, is found to be Substantiated. California Code of Regulations, Title 22 is being cited on the attached LIC 9099-D.

LPA toured the facility and observed clutter of papers and other house hold items in corners and on shelves, day care children snacks and food in a cubord that was all mixed together and mixed with the families own food and out of packages and no dates how long they have been in the cubord.Corners and base boards in the home had build up of dirt and kitchen had broccoli sitting on the counter in an open container next to hand soap.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 01/14/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2020

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 3 of 5

Control Number 33-CC-20200110140254

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: CAO & CHIANG FAMILY CHILD CARE	FACILITY NUMBER: 198018431
	VISIT DATE: 01/14/2020

NARRATIVE

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Kitchen freezer had spilled food, stuck to the base of the freezer that was cluttered and dirty with no labels or dates on food. Back yard had a small fence falling and poles holding up a tarp for shade was falling over and loose poles on the ground. Per Complainant the home is only cleaned once a week. Complainant states when the licensee clean the tables they use the broom they use to clean the floor to wipe the tables and not disinfectants. Per licensee they clean the floors each night with a swifter mop and wipe down the tables with a disinfecting wipe. Licensee states she understand the corners and base boards need to be clean and they need to be betters cleaners and organize and will.

Exit interview was conducted with Licensees Yan Ling Cao & Bob Chiang, including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site Inspection by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 01/14/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2020

LIC9099 (FAS) - (06/04)

Page: 4 of 5

Control Number 33-CC-20200110140254

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: CAO & CHIANG FAMILY CHILD CARE	FACILITY NUMBER: 198018431
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/14/2020

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 01/27/2020 Section Cited CCR 102417(b)	1 2 3 4 5 6 7	OPERATION OF A FAMILY CHILD CARE The home shall be kept clean and orderly, with ventilation for safety and comfort. This requirement is not met as evidenced by LPA observed clutter in corners and shelves, food mixed, out of packages, opened and no dates. Corners of floor with build up dirt. food on ounters next to cleaning supplies,	1 2 3 4 5 6 7	Licensee states she will have the facility cleaned up inside and outside and will send proof by the POC due date.
	8 9 10 11 12 13 14	The refrigerator/freezer in need of cleaning due to spilled and stuck on food and needs organized from day care food to family own food. Outdoor has broken shade with pole hanging down, metal fencing falling down. This poses a potential health and safety risk to the children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	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: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 01/14/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2020

LIC9099 (FAS) - (06/04)

Page: 5 of 5