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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020196
Report Date: 04/25/2019
Date Signed: 05/15/2019 09:15:52 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:BAO & YU FAMILY CHILD CAREFACILITY NUMBER:
198020196
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 0DATE:
04/25/2019
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Mei Yu & Wen Bao, Applicant's TIME COMPLETED:
03:30 PM
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Licensing Program Analyst (LPA) Carlos Gonzalez conducted a Pre-licensing inspection on this date. LPA met with Applicant’s, Mei Yu and Wen Bao, who guided Analyst on a tour of the facility. Currently residing at the facility (home), are both Applicant’s, Father/Father-in-law Nai Lin Yu, adult son Vincent Yu, and two (2) minor children. Applicant’s are requesting a small family day care license and are requesting to take care of children ages two (2) to six (6) years of age. Days and hours of operation will be from Monday thru Friday, 8:00 AM to 6:00 PM.

This is a two story home, consisting of five (5) bedrooms, four (4) bathrooms, a master bedroom with bathroom, two (2) living rooms, formal living room, formal dining room, den, kitchen, additional side kitchen, storage area, and a separate living quarters, located adjacent on the side of the 3-car garage. The home was inspected for comfort, cleanliness, telephone service, ventilation and heating. There is central air/heating in the home, LPA observed two (2) Air conditioning units, located outdoors.

Areas off-limits to children in care include the entire second floor, the formal living room (downstairs), dining room (downstairs), kitchen and side kitchen (downstairs), and the bathroom located within the bedroom used for napping purposes. LPA observed child proof gates within the downstairs foyer, to prevent children from gaining access to the formal living room, dining room, and second floor. Additional child proof gates were observed in the kitchen and rear staircase. Applicant’s understand that Licensing staff may have access to off-limit areas during inspection visits if necessary.

Per Applicant’s, there are no firearms, weapons, pets, or bodies of water on the premises. There are age appropriate toys for children. The valve on the 2-A:10-B:C fire extinguisher indicates fully charged and was recently purchased on 02/18/2019, per the receipt provided. The combination smoke/carbon monoxide detector was tested and is operable.
Report continues on next page 1 of 2
SUPERVISOR'S NAME: Katherine HarewoodTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Carlos GonzalezTELEPHONE: (323) 981-3381
LICENSING EVALUATOR SIGNATURE:

DATE: 04/25/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/25/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 2
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: BAO & YU FAMILY CHILD CARE
FACILITY NUMBER: 198020196
VISIT DATE: 04/25/2019
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Applicant’s have completed Preventive Health/Safety training and First Aid/CPR which expires on 11/17/2020.

The following was discussed with Applicant’s:
- Incidental Medical Services (IMS).
- Individual’s who are 18 years of age or older, living in the home, must obtain criminal record clearance.
- No smoking, No infant walkers, No Johnny Jumpers, No saucer chairs, or any similar item falling into that category, are permitted in the facility.

The following was also discussed with Applicant’s:
- Children’s forms/records, facility forms/records, and information to be posted, disaster drills, mandated child abuse, and injury/death reporting.

LPA will submit pre-licensing application to management for review and approval.

Exit interview conducted with Applicant’s Mei Yu and Wen Bao, who were in agreement with the above.
Report ends page 2 of 2
SUPERVISOR'S NAME: Katherine HarewoodTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Carlos GonzalezTELEPHONE: (323) 981-3381
LICENSING EVALUATOR SIGNATURE:

DATE: 05/15/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2019
LIC809 (FAS) - (06/04)
Page: 2 of 2