343622674-9-24-2021-53-CC-FDIZ-C76RFJ-20210924125913

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343622674
Report Date: 09/24/2021
Date Signed: 09/24/2021 12:59:22 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME:	LU, CHUNYING		FACILITY NUMBER:	343622674
ADMINISTRATOR:	LU, CHUNYING		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(209) 843-4335
CITY:	ELK GROVE	STATE: CA	ZIP CODE:	95757
CAPACITY:	14	CENSUS: 13	DATE:	09/24/2021
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Chunying Lu		TIME COMPLETED:	01:30 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	On 09/24/21 Licensing Program Analyst (LPA) Fabiola Diaz met with licensee Chunying Lu for an unannounced annual inspection. The facility hours of operation are 8:30am to 6pm Monday through Friday. Present in the facility was licensee’s own children, husband, and visiting mother-in-law. The home is a two story home, and the off-limit areas in the home are all upstairs, garage, and grassland section of backyard. Licensee acknowledges that children may never enter these off-limit areas. The outside play area is fenced and under a porch. Licensee was notified that prior to use of any off limits area, the department must be notified. A health and safety inspection was conducted in the areas accessible to children. The house has a working telephone, fully charged fire extinguisher, smoke detector and carbon monoxide detector that meet regulations. Licensee stated there is a weapon in the home. LPA observed the weapon and the ammunition to be locked together in a safe in an off-limit area out of the reach of children. No bodies of water were observed within the premises. Cleaning compounds and hazardous items were inaccessible to children. Safe toys and play equipment were observed. LPA observed all the required postings. The home does not have a fireplace. LPA advised the applicant that if there are any poisons at the home, all poisons must be locked with a key lock or combination lock. Stairs were barricaded meeting Title 22. LPA Diaz observed the record of licensee’s immunization in facility file. Children's roster and fire drill log were discussed. Licensee stated that she has not conducted a fire drill within the last 6 months, because she hasn't had many children due to COVID-19 but will conduct the fire drill as soon as possible. Licensee has EMSA pediatric CPR/First aid card that expires on 6/22. LPA did not observe current Mandated Reporter Training for licensee and assistant (husband). Licensee stated they will complete the training by 9/27/21. Report continues on 809C................

SUPERVISOR'S NAME: Jeanne Smith	TELEPHONE: (916) 263-2002
LICENSING EVALUATOR NAME: Fabiola Diaz	TELEPHONE: (916) 206-9352
LICENSING EVALUATOR SIGNATURE:	DATE: 09/24/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2021

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME: LU, CHUNYING	FACILITY NUMBER: 343622674
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/24/2021

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

102417(g)(4)(C)

Operation of A Family Child Care Home

(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children. (C) Ammunition shall be stored and locked separately from firearms. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and interview, the licensee did not comply with the section cited above in which poses an immediate health, safety or personal rights risk to persons in care. LPA observed the ammunition to not be stored seperately from the firearm. LPA observed the firearm and ammunition to be locked in a safe in an off-limit area out of the reach of children.
	POC Due Date: 09/25/2021
	Plan of Correction
1 2 3 4	Licensee will ensure to store and lock ammunition separately from the firearm by the POC due date. Licensee stated she does not operate on weekends, but will complete the POC by Saturday 9/25/21. The firearm and ammunition will be inspected by an LPA by Monday 9/27/21.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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: Jeanne Smith	TELEPHONE: (916) 263-2002
LICENSING EVALUATOR NAME: Fabiola Diaz	TELEPHONE: (916) 206-9352
LICENSING EVALUATOR SIGNATURE:	DATE: 09/24/2021

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2021

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME: LU, CHUNYING	FACILITY NUMBER: 343622674
	VISIT DATE: 09/24/2021

NARRATIVE

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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

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Licensee was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

The following Title 22 Deficiencies are being cited on the subsequent 809-D pages. Upon receipt of Type A citations, licensee shall post and provide copies of the LIC 809-D for parents/guardians of children in care and for parents/guardians of newly enrolled children for the next 12 months. Licensee must also keep the signed LIC 9224, acknowledging receipt of LIC 809-D in each child's file. Appeal Rights and Notice of Site Visit were provided. Notice of Site Visit must remain posted for 30 days. Exit interview was conducted and report was reviewed with the licensee Chunying Lu.

SUPERVISOR'S NAME: Jeanne Smith	TELEPHONE: (916) 263-2002
LICENSING EVALUATOR NAME: Fabiola Diaz	TELEPHONE: (916) 206-9352
LICENSING EVALUATOR SIGNATURE:	DATE: 09/24/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2021

LIC809 (FAS) - (06/04)

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