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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364845390
Report Date: 07/05/2019
Date Signed: 07/05/2019 12:02:47 PM

COMPREHENSIVE INSPECTION
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:MU FAMILY CHILD CAREFACILITY NUMBER:
364845390
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 5DATE:
07/05/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
10:09 AM
MET WITH:Juan Juan MuTIME COMPLETED:
12:05 PM
NARRATIVE
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Licensing Program Analyst (LPA) Kim Leung arrived at the facility to conduct a comprehensive inspection. Upon arrival, LPA met with licensee Juan Juan Mu and assistant provider Jane Koo and stated the purpose of the visit. Access to the facility was granted by the licensee. Licensee's primary language is Mandarin and therefore this inspection was conducted in Mandarin. LPA toured the facility, inside and out, records were reviewed and the following was observed and/or discussed:
Normal days and hours of operation are: Monday through Friday from 8am to 6pm
OFF-LIMIT AREAS INCLUDE: entire upstairs, kitchen and garage. The door to the garage was not locked and licensee was advised to lock the door to prevent access by children to the off limit garage.
The facility is operating within the licensed capacity and appropriate ratios
· Appropriate supervision provided during this inspection
· A working telephone is present
· Fully-charged fire extinguisher rated 3A:40BC is present. Smoke detector and carbon monoxide detector are present and were tested by the applicant during this inspection. Smoke detector and carbon monoxide detector are in working order.
· Regulatory requirements of storage of hazards were reviewed with licensee during this inspection
· No guns or weapons present as stated by the Licensee. Licensee understands all guns, weapons and ammunition must be key-locked separately and made inaccessible per Title 22 Regulations
· Stairs are barricaded at the bottom
· Verification of control of property on file (rental agreement)
· License, Facility Sketch, Emergency Disaster Plan & Notification of Parent’s Rights poster are posted
· Pediatric CPR and First Aid Card - expire on 2/9/2021
· Health & Safety Certificate - completed on 2/6/2016
· There are no bodies of water at this home as of this date. Licensee stated that she understood that all bodies of water including ponds, above ground pools and spas, in-ground pools and spas, and some fountains must be properly covered or fenced per title 22 regulations. The Department must be notified before and after installation of the above types of bodies of water. In addition, all wading pools or similar product must be emptied immediately after use and stored in an upright position when not in use. There is a community pool within walking distance. The pool is surrounded by 5-foot
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 784-4200
LICENSING EVALUATOR NAME: Kim LeungTELEPHONE: (951) 529-4713
LICENSING EVALUATOR SIGNATURE:

DATE: 07/05/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/05/2019
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 5
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: MU FAMILY CHILD CARE
FACILITY NUMBER: 364845390
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/05/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/08/2019
Section Cited
CCR
102417(g)(8)
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Operation of a Family Child Care Home. Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841. This requirement was not met as evidenced by: As stated by licensee, the first child care child started receiving care at this facility in May, 2019. However, no roster is
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Licensee Juan Juan Mu agreed to maintain current roster at all times. Copy of roster will be submitted to the Department by 7/8/2019.
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maintained as stated by licensee. Failure to maintain a current roster presents potential risks to the children's safety.
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Type B
07/08/2019
Section Cited
CCR
192417(g)(7)
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Operation of a Family Child Care Home. An emergency information card shall be maintained for each child and...parent's authorization for the licensee or registrant to consent to emergency medical care. This requirement was not met as evidenced by: No written consent for emergency medical treatment for Child #4 is available for review
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Licensee Juan Juan Mu agreed to submit the signed LIC627 Consent for Emergency Medical Treatment to the Department by 7/8/2019 after obtaining the completed form from parent.
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during inspection. Licensee stated that no additional records are available for review at this time. That presents potential risks to the child's health and safety when emergency medical treatment becomes necessary.
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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) 784-4200
LICENSING EVALUATOR NAME: Kim LeungTELEPHONE: (951) 529-4713
LICENSING EVALUATOR SIGNATURE:

DATE: 07/05/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/05/2019
LIC809 (FAS) - (06/04)
Page: 2 of 5
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: MU FAMILY CHILD CARE
FACILITY NUMBER: 364845390
VISIT DATE: 07/05/2019
NARRATIVE
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tall wrought iron fence with self-closing gates with key-locks.
· Clean, safe and age appropriate toys. There are no toxic plants at this time
· No roster maintained as stated by licensee
· Documentation of fire drills on file. The most recent disaster drill was conducted on 6/19/19 as stated by licensee. Licensee agreed to conduct a disaster drill with children within a week and submit the drill log to the Department no later than 7/12/2019.
· Children’s records are complete
· Employee’s records are not complete
· Criminal record clearances are required prior to all adults living or working in a Family Child Care Home. A civil penalty of $100.00 per day the person has been present, may be assessed. Resident and/or staff records reviewed on indicate that all adults who require caregiver background checks have received all required clearances or exemptions.
· Facility is not currently providing IMS Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided an updated Plan of Operation that includes 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
· For more information on SIDS and Safe Sleep Environments, please visit:
California Department of Public Health – California SIDS Program: http://www.cdph.ca.gov/programs/SIDS/pages/default.aspx
AAP – Safe Sleep Campaign: http://www.healthychildcare.org/sids/html
AAP-Free Training: Reducing the Risk of SIDS in Early Education and Child Care: http://shop.aap.org/Reducing-the-Rick-of-SIDS-in-Early-Education-and-Child-Care
And Caring for our Children, Safe Sleep Practices and SIDS/Suffocation Risk Reduction: http://cfoc/nrckids/org/standardview/spccol/safe_sleep
The following was reviewed with the licensee(s):
- AB 1207 – Mandated Child Abuse Reporting: Child Day Care Personnel Training, beginning January 1, 2018 – In accordance with California Health and Safety Code Section 1596.8662 – requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Applicants must meet requirements as a precondition to licensure. Existing licensees must meet requirements by March 30, 2018. New employees shall have 90 days to complete training as required. This training requirement may be directly met by using the Department’s Office of Child Abuse Prevention (OCAP) online training modules. The OCAP modules are free of cost and available at: http://www.mandatedreporterca.com/ and are provided in English and Spanish. If no training is made available in a required person’s primary language then those persons shall be exempt from this requirement. Assistant provider Jane Koo agreed to complete the training as required.
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 784-4200
LICENSING EVALUATOR NAME: Kim LeungTELEPHONE: (951) 529-4713
LICENSING EVALUATOR SIGNATURE:

DATE: 07/05/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/05/2019
LIC809 (FAS) - (06/04)
Page: 4 of 5
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: MU FAMILY CHILD CARE
FACILITY NUMBER: 364845390
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/05/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/19/2019
Section Cited
CCR
102369(b)(9)
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Application for Initial License. Evidence of a current tuberculosis clearance, not more than one year...for any adult in the home during the time that children are under care. This requirement was not met as evidenced by: Assistant provider does not have a TB test report on file. As stated by assistant, TB test has not been done yet.
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That presents potential risks to the children's health and safety. Licensee Juan Juan Mu agreed to submit copy of assistant's current TB test report with result to the Department by 7/19/2019.
Type B
07/19/2019
Section Cited
HSC
1597.622(a)
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SB792 Employees or volunteers at family day care home; immunization requirements; records; exemptions. Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive
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That presents potential risks to the children's health and safety. Licensee Juan Juan Mu agreed to submit copy of assistant's current TB test report with result to the Department by 7/19/2019.
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an influenza vaccination between August 1 and December 1 of each year. This requirement was not met as evidenced by: Immunization records for assistant provider were not available for reviewed during inspection. As stated by assistant, immunizations have not been done yet.
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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) 784-4200
LICENSING EVALUATOR NAME: Kim LeungTELEPHONE: (951) 529-4713
LICENSING EVALUATOR SIGNATURE:

DATE: 07/05/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/05/2019
LIC809 (FAS) - (06/04)
Page: 3 of 5
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: MU FAMILY CHILD CARE
FACILITY NUMBER: 364845390
VISIT DATE: 07/05/2019
NARRATIVE
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Other updates were provided to the licensee during inspection on 2/28/2019. See LIC809 Facility Evaluation Report dated 2/28/2019.

- Access to forms & Regulations for Family Child Care online at www.ccld.ca.gov.
- Please subscribe at www.childcareadvocatesprogram@dss.ca.gov to receive Department updates. They will be sent directly to your e-mail account once you have set up an account. This website can also be accessed through www.ccld.ca.gov
- The Duty Officer is available to answer questions Monday – Friday at 1-844-LET-US-NO (1-844-538-8766).

During inspection, licensee was advised to visit the following websites for information and guidance on safe sleep practices:
https://www.healthychildren.org/English/ages-stages/baby/sleep/Pages/A-Parents-Guide-to-Safe-Sleep.aspx
https://safetosleep.nichd.nih.gov/safesleepbasics/environment/room/text_alternative
https://safetosleep.nichd.nih.gov/materials

See LIC809D for cited deficiencies. Appeal rights discussed and a copy of this report was provided to the licensee on this date. During the exit interview, licensee Juan Juan Mu confirmed that there are no Registered Sex Offenders living in the facility and/or using the facility address for their mailing address.

Licensee has requested for capacity increase to a large family child care. A fire clearance has been obtained on 6/25/2019. Capacity increase will be submitted for approval after all required corrections have been completed with proof of corrections submitted the Department.

A NOTICE OF SITE VISIT WAS ISSUED AND IS TO BE POSTED IN A PROMINENT LOCATION AT THE FACILITY FOR THE NEXT 30 DAYS. This report must be made available to the public upon request for the next 3 years.
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 784-4200
LICENSING EVALUATOR NAME: Kim LeungTELEPHONE: (951) 529-4713
LICENSING EVALUATOR SIGNATURE:

DATE: 07/05/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/05/2019
LIC809 (FAS) - (06/04)
Page: 5 of 5