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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343622674
Report Date: 09/28/2023
Date Signed: 09/28/2023 12:32:36 PM

Document Has Been Signed on 09/28/2023 12:32 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:LU, CHUNYINGFACILITY NUMBER:
343622674
ADMINISTRATOR:LU, CHUNYINGFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 843-4335
CITY:ELK GROVESTATE: CAZIP CODE:
95757
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 13DATE:
09/28/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Chunying LuTIME COMPLETED:
12:45 PM
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Licensing Program Analyst (LPA) Corina Beckby met with Licensee, Chunying Lu, on 09/28/2023 for the purpose of an unannounced plan of correction inspection to clear all deficiencies, issued on 09/26/2023.

LPA observed Licensee and assistant caring for 12 preschool children and one school age child during today's inspection. LPA toured the facility and found no deficiencies.



Licensee disenrolled necessary number of children to be in ratio with a large license. Licensee states she does not enroll infants. Licensee understands she can only care for 12 preschool children, or up to 14 if one is enrolled and attending Kindergarten and the other school age child is 6 years or older. LPA gave Licensee a poster regarding the maximum number of children allowed for a large license, and Licensee will post it where she can see it daily as a reminder.

All enrolled families have signed LIC9224 Acknowledgement of Licensing Reports forms.

LPA observed updated roster.

LPA observed 2 Mandated Reporter Certificates that expire on 9/28/25.

All deficiencies cited on 09/26/2023 are cleared effective today. Proof of correction letters were provided for the corrected deficiencies. LPA reviewed report with Licensee, Chunying Lu. Appeal Rights were provided. A notice of site visit was posted by LPA and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Corina Beckby
LICENSING EVALUATOR SIGNATURE: DATE: 09/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/28/2023
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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