<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334845740
Report Date: 04/05/2021
Date Signed: 04/06/2021 08:30:16 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:HSIAO FAMILY CHILD CAREFACILITY NUMBER:
334845740
ADMINISTRATOR:HSIAO,WEI-HSINFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(951) 268-0906
CITY:EASTVALESTATE: CAZIP CODE:
92880
CAPACITY:14CENSUS: 1DATE:
04/05/2021
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
04:35 PM
MET WITH:Wei-Hsin HsiaoTIME COMPLETED:
05:30 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Due to COVID-19, in lieu of an in-person inspection, Licensing Program Analyst (LPA) Kim Leung conducted a tele-inspection with licensee Wei Hsin Hsiao via FaceTime to investigate a complaint. At the beginning of the tele-inspection, LPA informed licensee the purpose of the inspection. At time of the inspection, the licensee gave LPA a virtual tour to the facility.

During the investigation process, LPA obtained information that the facility called law enforcement for multiple times during January 2021 and February 2021. LPA obtained information that there were police activities at the facility while children were in care on 1/25/2021, 1/26/2021, 2/16/2021 and 2/25/2021. However, the facility failed to report the incidents to the Department as required except for after LPA reviewed the reporting requirements with the licensee during inspection on 3/5/2021, an unusual incident report was received from the licensee on 3/7/2021 on the incident occurred on 1/26/2021. At this present time, there were no other reports received from the facility on those other incidents. Facility failed to comply with the reporting requirements.

In 2020, licensee notified the Department that the facility was closed in mid March, 2020 and did not reopen until 10/1/2020 due to the COVID-19 pandemic. However, during the investigation process, LPA obtained information that the facility actually reopened in June 2021 and children returned to child care on 6/15/2021. Facility failed to notify the Department prior to or after it has reopened in June 2021. During contacts with the Department on 9/1/2020, licensee agreed to notify the Department once a reopening date had been determined. On 9/30/2020, licensee notified the Department that the facility would reopen on 10/1/2020. Licensee provided untrue information to the Department regarding the operation of the facility.

See LIC809D fir deficiencies cited per California Code of Regulations, Title 22, Division 12.

Exit interview conducted with licensee Wei Hsin Hsiao. LPA provided licensee with a copy of this report and Notice of Site Visit via email this date on 4/5/2021. Appeal rights were explained. Licensee agreed to acknowledge receipt of the email. An electronic “read receipt” was also attached. The electronic read receipt of the emailed report acknowledges receipt of this report.
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Kim LeungTELEPHONE: (951) 529-4713
LICENSING EVALUATOR SIGNATURE:

DATE: 04/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2021
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 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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: HSIAO FAMILY CHILD CARE
FACILITY NUMBER: 334845740
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/05/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/07/2021
Section Cited

1
2
3
4
5
6
7
Reporting Requirements. The licensee shall report to the Department any of the events as specified in Health and Safety Code Sections 1597.467(b)(1)(A) through (b)(1)(C) that occur during the operation of the family child care home. This requirement was not met as evidenced by: The facility called law enforcement for multiple times during
8
9
10
11
12
13
14
January 2021 and February 2021. There were police activities at the facility while children were in care on 1/25/2021, 1/26/2021, 2/16/2021 and 2/25/2021. Licensee failed to report the incidents to the Department as required. That presented potential risks to the children's health and safety.
8
9
10
11
12
13
14
Type B
04/07/2021
Section Cited

1
2
3
4
5
6
7
Revocation or Suspension of a License or Registration. The Department shall have the authority to suspend or revoke any license for the following reasons: Conduct in the operation or maintenance of a family day care home which is inimical to the health, morals, welfare, or safety of either an individual in or receiving services from the
8
9
10
11
12
13
14
facility or the people of the State of California. Licensee provided untrue statement to the Department and that was evidenced by: In 2020, licensee notified the Department that the facility was closed in mid March, 2020 and did not reopen until 10/1/2020 due to the COVID-19 pandemic. In fact, children returned for care on 6/15/2021.
8
9
10
11
12
13
14
Licensee Wei Hsin Hsiao agreed to immediately cease providing untrue or misleading information to the Department. Licensee agreed to submit a written statement of understanding to the Department by 4/7/2021.
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: Aaron RossTELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Kim LeungTELEPHONE: (951) 529-4713
LICENSING EVALUATOR SIGNATURE:
DATE: 04/05/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/05/2021
LIC809 (FAS) - (06/04)
Page: 2 of 2