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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198018811
Report Date: 11/08/2023
Date Signed: 11/16/2023 04:36:17 PM


Document Has Been Signed on 11/16/2023 04:36 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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754



FACILITY NAME:SU-LY FAMILY CHILD CAREFACILITY NUMBER:
198018811
ADMINISTRATOR:SU-LY, LING HSIAOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 230-4185
CITY:ALHAMBRASTATE: CAZIP CODE:
91801
CAPACITY:14CENSUS: 7DATE:
11/08/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Ling Su-Ly TIME COMPLETED:
03:30 PM
NARRATIVE
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Licensing Program Analyst (LPA) Seung Lee conducted an unannounced case management inspection. Upon arrival LPA Lee met with Licensee Ling Su-Ly.

The purpose of the inspection was to address an observation made during a prior inspection. It was observed that on 10/27/2023. Licensee was present with 6 children in care and 1 child who the Licensee's own child. The Licensee's child/infant was observed to sleeping in an off limits bedroom while the Licensee was alone in the home until an assistant arrived shortly after 3pm. This is a potential risk to children in care. Please see the attached 809D for details on the deficiency.

A hard copy of the legal declaration Licensee signed on 10/27/23 was provided during the inspection by the Licensee. The declaration stated that the Licensee will not have her own infant sleeping in an off limits area of the home if she is alone in the home during business hours.

The notice of site inspection must remain posted for a period of 30 days during hours of operation. Failure to maintain posting will result in a civil penalty of $100.00 dollars.

Exit interview conducted with Licensee Ling Su-Ly. Appeal rights discussed and explained.
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) -98-3391
LICENSING EVALUATOR NAME: Seung LeeTELEPHONE: (323) 981-3382
LICENSING EVALUATOR SIGNATURE:
DATE: 11/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/08/2023
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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Document Has Been Signed on 11/16/2023 04:36 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754


FACILITY NAME: SU-LY FAMILY CHILD CARE
FACILITY NUMBER: 198018811

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/08/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/08/2023
Section Cited
CCR
102416.3(a)(6)

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Any change from an area of the family child care home previously identified as "off limits" to an area where care and supervision will be provided to children in care. This requirement was not met as evidenced by the fact that on 10/27/23 from 1pm-3pmThe Licensee was alone with 6 day care children in the main
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Licensee stated that she will not have her own infant child stay in an off limits room of the home while she is the only adult present.
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 area of care while at the same time Licensee’s own infant child, was observed to be sleeping in an off limits bedroom. This is a potential risk to 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: Claudia GuangorenaTELEPHONE: (323) -98-3391
LICENSING EVALUATOR NAME: Seung LeeTELEPHONE: (323) 981-3382
LICENSING EVALUATOR SIGNATURE:
DATE: 11/08/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/08/2023
LIC809 (FAS) - (06/04)
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