198019530-2-6-2025-33-CC-NTCG-DDMTWV-20250206140610

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198019530
Report Date: 02/06/2025
Date Signed: 02/06/2025 02:06:22 PM

Document Has Been Signed on 02/06/2025 02:06 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	CHANG & MONTEAGUDO FAMILY CHILD CARE		FACILITY NUMBER:	198019530
ADMINISTRATOR/ DIRECTOR:	CHANG & MONTEAGUDO		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(626) 841-0505
CITY:	ARCADIA	STATE: CA	ZIP CODE:	91007
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 9	DATE:	02/06/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	11:25 AM
MET WITH:	David Chang - Licensee		TIME VISIT/ INSPECTION COMPLETED:	02:20 PM

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Licensing Program Analyst (LPA) Nolan Tcheng conducted an unannounced annual random inspection to the above facility. At 11:25am, LPA met with MeiYing Chang and Ellaine Thong, assistants. Licensee David Chang arrived at 11:40am, and stated they were at another property that they own. Licensee discussed with LPA that they only stepped away from the facility momentarily. LPA was able to confirm Licensee lives in the home and is here during the operation hours. The licensee states that they currently have 10 children enrolled. A current children’s roster is available and is current. Licensee’s hours of operation are 8am-6pm Monday-Friday.

This is a one-story home which consists of 3 bedrooms (one is large play room), 2.5 bathrooms, kitchen, living room, Laundry room, play room, detached garage, front yard and backyard (fenced). The children use one bedroom, living room, kitchen, small classroom, and back play room. Per licensee, areas off limits to children and parents include: Licensee bedroom, bathroom, detached garage, back yard and front yard. All areas identified on the facility sketch were inspected. The licensee provides food for children in care.

The licensee states that 1 adult and 0 minors currently live in the home. Persons living in the home are identified on the attached LIC811. Licensee states that they currently have two assistants. All individuals present in the home have obtained a criminal record clearance or exemption prior to working, residing or volunteering in a licensed home. Per licensee, there are no weapons, firearms or bodies of water on the premises.

At 11:40am, LPA was led on a tour of the facility by the licensee. Upon entry into the home, the living room was reviewed. Emergency Disaster Plan, Parent’s Rights Poster and the Facility License are observed to be posted. 9 children were being placed down for nap time. Cots were observed to be napping equipment. Fireplaces and open face heaters are inaccessible to prevent access by children. Tour continued through to the kitchen. High chairs were observed. Per licensee, they are only used for lunch and meal time. Detergents, cleaning compounds, medications, and other items which could pose a danger are inaccessible to children. REPORT CONTINUES PAGE 1 of 3

Ana Chico	TELEPHONE: (323) 981-3351
Nolan Tcheng	TELEPHONE: (323) 240-6201
	DATE: 02/06/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2025

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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: CHANG & MONTEAGUDO FAMILY CHILD CARE	FACILITY NUMBER: 198019530
	VISIT DATE: 02/06/2025

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Tour continued through the laundry room. There is a restroom available for children in care to use and was observed to be safe and free of hazards. Adjacent to the laundry room is a small nook/room that is used as a partial classroom. It connects to the back play room. LPA observed play yards for children in care. There were plenty of age appropriate toys and equipment. Smoke and carbon monoxide detectors were tested and are operable. There are first aid supplies available.

Tour returned back through the living room to the other side where there was as small hallway. To the left in the hallway is a bedroom used as a nap room for children in care. There were cribs available in the room that did not disrupt staff view of children during nap time and allowed access to exit. The licensee states that there are no poisons in the home and understands that storage areas for poisons must be locked with a key or combination lock.

At this time, Licensee states children are not brought outside and that both the front and back yard are off limits. The licensee is observed to be operating within the license capacity limitations.

At 12:30pm, facility records were reviewed. The licensee and other personnel have completed training on preventive health practices including Pediatric First Aid and CPR. The licensee's Pediatric First Aid and CPR expires on 04/2025. Licensee and other personnel have complete mandated reporter training that 04/08/2025. The licensee does have proof of immunization against influenza, tuberculosis, pertussis, and measles. Children’s records were reviewed, including but not limited to, a copy of the emergency information card that contains all the information specified by regulation. During review, Licensee was unable to provide LPA with 3 of 10 children files for review. LPA discussed that they are required to be available for review whenever inspections are conducted. LPA also observed that LIC9227 Individual Infant Sleeping PLan was not completed for applicable child in care. LPA address the issue with licensee and provided the form.

The following was discussed:

-There are no pets on the premises.
-Infant Walkers, Johnny Jumpers, Saucer Chairs, and/or any other item that falls into these categories are not permitted in a family child care facility.
-Smoking is prohibited in a license family child care home.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California. REPORT CONTINUES PAGE 2 of 3

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3351
LICENSING EVALUATOR NAME: Nolan Tcheng	TELEPHONE: (323) 240-6201
LICENSING EVALUATOR SIGNATURE:	DATE: 02/06/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2025

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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: CHANG & MONTEAGUDO FAMILY CHILD CARE	FACILITY NUMBER: 198019530
	VISIT DATE: 02/06/2025

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To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. 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: https://www.ada.gov/resources/child-care-centers/.

During the exit interview, Licensee, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

Based on the LPA’s observations and records review, the following deficiencies listed on the attached LIC 809 (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health & safety

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee David Chang, at 2pm. Copy of Report provided and Plan of Corrections developed. END OF REPORT PAGE 3 of 3

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3351
LICENSING EVALUATOR NAME: Nolan Tcheng	TELEPHONE: (323) 240-6201
LICENSING EVALUATOR SIGNATURE:	DATE: 02/06/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2025

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 02/06/2025 02:06 PM - It Cannot Be Edited

Created By: Nolan Tcheng On 02/06/2025 at 01:39 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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

FACILITY NAME: CHANG & MONTEAGUDO FAMILY CHILD CARE	FACILITY NUMBER: 198019530
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/06/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102421(b)

Child's Records

(b) The licensee shall maintain, in each child's record, a copy of the emergency information card as required in Section 102417(g)(7). This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview and record review, the licensee did not comply with the section cited above in 3 of 10 Children Files, Child #7, 9-10, were not available for file review during inspection, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 02/20/2025
	Plan of Correction
1 2 3 4	Per Licensee, they will find locate the files of Child #7, 9, & 10, and send them to LPA by POC date. Child #4 immunizations will be submitted as well.

Type B

Section Cited

CCR

102425(c)

Infant Safe Sleep

An Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be completed for each infant up to 12 months of age the provider has in care and included in the infant's file at the facility. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview and record review, the licensee did not comply with the section cited above 1 of 10 files, Child #2, did not have a completed Individual Infant Sleeping Plan (LIC9227), which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 02/13/2025
	Plan of Correction
1 2 3 4	Per Licensee, they will have the parent of CHild #2 complete the LIC9227 Individual Infant Safe Sleep form, and submit proof to LPA by POC date.

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) 981-3351

LICENSING EVALUATOR NAME:

Nolan Tcheng

TELEPHONE: (323) 240-6201

LICENSING EVALUATOR SIGNATURE:

DATE: 02/06/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2025

LIC809 (FAS) - (06/04)

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