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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020320
Report Date: 06/22/2021
Date Signed: 06/22/2021 11:15:56 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:YAN FAMILY CHILD CAREFACILITY NUMBER:
198020320
ADMINISTRATOR:YAN H. YANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 673-8863
CITY:SOUTH EL MONTESTATE: CAZIP CODE:
91733
CAPACITY:14CENSUS: 1DATE:
06/22/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Licensee Yan H. Yan TIME COMPLETED:
11:30 AM
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At 8:30 am Licensing Program Analysts (LPA) Roxana Lopez conducted an unannounced required 1 year inspection to the above facility. LPA met with Yan H. Yan, Licensee who guided analysts on a tour of the facility. Also present during this inspection, was Licensee’s Mother, Father and two adult daughters. Per Licensee, there are 12 children that are currently enrolled. A current children’s roster was available for review. There was 1 child present upon arrival. The second child arrived at 8:40 and the 3rd and 4th child arrived at 8:45 am.

The licensee states that 7 adults and 0 children currently live in the home. Per Licensee, she currently has one assistant. All adults present in the home have obtained a criminal record clearance or exemption prior to working, residing or volunteering in the licensed child care home. Licensee states that there are no firearms stored in the home.

This is a two story home which consists of 5 bedrooms, 6 restrooms, 1 study room, 1 bar room, dining room, living room, kitchen, laundry room, front yard, back yard (fenced) and garage. Per Licensee, the children will use the first floor of the home; The restroom located near the laundry room, the children's playroom and the infant area located in the bar room. At this time LPA did not observed any alcohol accessible to children in this area. The living room is used as a walkway to the day care area. Per licensee, areas off limits to children and parents include: 5 bedrooms, 5 bathrooms, dining room, living room, kitchen, laundry room, front yard and garage. The LPA toured all areas used by children during this visit.

All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. There is telephone service via a cellphone that is used and the cellphone stays at the facility during operation hours. There is ventilation and heating (central). The following was observed and reviewed during this inspection.
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SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Roxana LopezTELEPHONE: (323) 854-5073
LICENSING EVALUATOR SIGNATURE:

DATE: 06/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/22/2021
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 5
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: YAN FAMILY CHILD CARE
FACILITY NUMBER: 198020320
VISIT DATE: 06/22/2021
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Detergents, cleaning compounds, medications, and other items which could pose a danger to children were not observed to be inaccessible to children. 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. The restroom that children use was observed to be safe and sanitary.

The valve on the required 2A 10BC fire extinguisher indicates fully charged and was serviced on 06/21/2021, as indicated on service tag. Smoke and carbon monoxide detectors were tested and are operable. All homes shall conduct fire and disaster drills at least once every six months, and document the date and time of each drill. Last drill documented was conducted on 06/01/2021.

Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted in the infant room area.

The home is observed to be clean and orderly. Where children less than five years old are in care, stairs are fenced or barricaded. There is a child safety gate which keeps stairs inaccessible to children. There are toys available for children. Appropriate sleeping arrangements in form of mats and playpens were observed.

Licensee states that she is currently caring for infants. LPA advised the licensee to sleep infants where they can always be directly supervised and advised the licensee against sleeping infants in a separate room. Licensee states that infants sleep in the day care room, where they are constantly supervised.

At 8:41 am LPA did observe a small trampoline in the daycare room. LPA explained that the trampoline was not safe to use and advise Licensee to abide by the manufactures rules of usage. Per Licensee, it was too much responsibility and preferred removing it. During the inspection LPA observed Licensee’s father removing the trampoline from the day care room and putting it outside on the street. LPA did not observed the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs, and/or any other item that fall into these categories are not permitted in a family child care facility.

Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.

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SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Roxana LopezTELEPHONE: (323) 854-5073
LICENSING EVALUATOR SIGNATURE:

DATE: 06/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/22/2021
LIC809 (FAS) - (06/04)
Page: 2 of 5
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: YAN FAMILY CHILD CARE
FACILITY NUMBER: 198020320
VISIT DATE: 06/22/2021
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Currently, children are using the back yard for outdoor play time. The outdoor play area was observed to be fenced. LPA observed that the outdoor yard has toys and other materials for children to play with. LPA did not observe any objects that can pose a danger to children on the outdoor yard.

Per Licensee, she has one cat and a fish tank which are kept in an off limits area during operating hours.

At 9:50 am children’s records were reviewed, LPA observed that Child 1, 2, 5,8 and 9 were missing immunization record.

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 06/2023. There are first aid supplies available.

The licensee does have proof of immunization against influenza, pertussis, and measles.

At 10:10 LPA observed that the Licensee and assistant do not have proof of the Mandated Reporter AB 1207 compliant Child Care Training Certificate on file. Mandated Reporter Training: H&S 1596.8662: Beginning January 1, 2018, all licensed providers, applicants, directors and employees to complete training as specified on mandated reporter duties. Training is available at: www.mandatedreporterca.com

LPA issued a Confidential Names List (LIC 811) to the licensee which children’s files reviewed during this inspection.



Incidental Medical Services (IMS):
The licensee states that she will provide IMS. Per licensee, there are no children enrolled that require IMS 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.
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SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Roxana LopezTELEPHONE: (323) 854-5073
LICENSING EVALUATOR SIGNATURE:

DATE: 06/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/22/2021
LIC809 (FAS) - (06/04)
Page: 3 of 5
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: YAN FAMILY CHILD CARE
FACILITY NUMBER: 198020320
VISIT DATE: 06/22/2021
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LPA advised the licensee to access forms, regulations and quarterly updates on line at: www.ccld.ca.gov.

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 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.

Based on the LPA’s observations and records review, the following deficiencies listed on the attached LIC 809D (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.


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

Exit interview was conducted with Yan H. Yan, Licensee including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role and their signature on this form acknowledges receipt of these forms.

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SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Roxana LopezTELEPHONE: (323) 854-5073
LICENSING EVALUATOR SIGNATURE:

DATE: 06/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/22/2021
LIC809 (FAS) - (06/04)
Page: 4 of 5
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: YAN FAMILY CHILD CARE
FACILITY NUMBER: 198020320
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/22/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/02/2021
Section Cited

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On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated
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 reporter training every two years following the date on which he or she completed the initial mandated reporter training.
This requirement was not met as evidence by LPA's observations and document reviews both Licensee and Assistant do not have proof of training. This poses a potential risk for the health and safety of children in care
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Type B
07/02/2021
Section Cited

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102418 (a) Immunizations- Prior to admission to a family day care home, children shall be immunized against diseases as required by the California Code of Regulations, Title 17, beginning with Section 6000. This requirement was not met as evidence by
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Upon LPA's observations and documents reviewed Child 1,2 5,6,8 and 9 are missing proof of immunizations. This poses a potential risk for 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 VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Roxana LopezTELEPHONE: (323) 854-5073
LICENSING EVALUATOR SIGNATURE:
DATE: 06/22/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/22/2021
LIC809 (FAS) - (06/04)
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