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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304312921
Report Date: 03/16/2021
Date Signed: 03/16/2021 11:22:00 AM

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:ZHANG, MING & ZHANG, HANJIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(949) 887-3581
CITY:IRVINESTATE: CAZIP CODE:
92620
CAPACITY:14CENSUS: 11DATE:
03/16/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:10 AM
MET WITH: Mingqiong Zhang and Hanjie Zhang - licenseesTIME COMPLETED:
10:40 AM
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Tele-inspection dus to COVID 19 State of Emergency

LPA Chan conducted a tele inspection at the facility. LPA met with licensees Mingqiong Zhang and Hanjie Zhang. A facility tour was conducted and census was taken. The purpose of the tele inspection is to deliver an amended report.

Exit interview was conducted. A copy of this report will be provided through email and the licensee’s signature on this form acknowledges receipt of the report. (The "Read Receipt" or licensee's email is in lieu of a signature). The Notice of Site Visit was not posted due to tele-investigation Covid-19 State of Emergency.
SUPERVISOR'S NAME: Rina LopezTELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Ryan Joseph ChanTELEPHONE: (714) 287-0708
LICENSING EVALUATOR SIGNATURE:

DATE: 03/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2021
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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