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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304312921
Report Date: 11/22/2019
Date Signed: 11/22/2019 04:07:01 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:ZHANG, MINGQIONG & ZHANG, HANJIEFACILITY NUMBER:
304312921
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 5DATE:
11/22/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:20 PM
MET WITH:Mingqiong Zhang TIME COMPLETED:
04:20 PM
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Licensing Program Analyst (LPA) Connolly made a case management inspection to this home to ensure regulation compliance as licensees have applied for a large family child care home license. Fire clearance has been received in the licensing office 11/12/19.

Present during today's inspection was licensee Mingqiong Zhang and five children in care. Of the five children in care two were infants and three were preschool age. All children were awake and actively engaged in the activities of the day care.

A review of criminal clearance records on this date indicates adults who require caregiver background checks have received criminal record and child abuse index clearances.

LPA reviewed regulations regarding staffing and ratio, supervision, criminal record clearances and assuring items which can pose a danger to children are stored inaccessible to children in care.

LPA provided a copy of the dangers of lead poisoning, a copy of what a safe sleep environment for infants in care looks like, a form to document fire and disaster drills and a copy of the Child Care Licensing E-Learning Modules available to view on line.

No deficiencies were observed. License for a large family child care home to be issued as of today's date. Exit interview was conducted. Notice of Site Visit posted.
SUPERVISOR'S NAME: Rina LopezTELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Gesine ConnollyTELEPHONE: (714) 293-9314
LICENSING EVALUATOR SIGNATURE:

DATE: 11/22/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2019
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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