364845981-2-24-2021-09-CC-NZUA-BYK29R-20210224161222

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 364845981
Report Date: 02/24/2021
Date Signed: 02/24/2021 04:14:21 PM

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:	SHEN FAMILY CHILD CARE		FACILITY NUMBER:	364845981
ADMINISTRATOR:	SHEN,WEI		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(415) 860-5818
CITY:	ONTARIO	STATE: CA	ZIP CODE:	91762
CAPACITY:	14	CENSUS: 0	DATE:	02/24/2021
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	01:15 PM
MET WITH:	Wei Shen		TIME COMPLETED:	04:30 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 date and time listed, Licensing Program Analyst (LPA) Nelson Zuniga conducted a pre-licensing tele-inspection via Face-time with the applicant, due to COVID-19 and DPH guidelines of social distancing. A tour of the facility was conducted via Face-time, the applicant took LPA through the entire inside and outside of the facility. LPA referred to the facility sketch as well, throughout the tour. A copy of the Pre-Licensing Booklet along with Child Care Program COVID-19 Self-Assessment packet were mailed and today they were reviewed with Ms. Wei Shen. Applicant has applied for a large family child care license. A fire clearance was issued and received from Ontario Fire Department. The following was observed and/or discussed: Days and hours of operation are Monday - Friday 7:00am - 6:00 pm. Ages to be served: 6 months to 6 years of age. Off-limit areas include: Garage, kitchen area and upstairs which include four bedrooms and 2 baths. · Appropriate fire extinguisher, smoke detector and carbon monoxide detector are present. Fire extinguisher, smoke detector and carbon monoxide detector are in working order. · All hazardous items are not inaccessible: See corrections · Toxins and poisons are locked. · No guns or weapons present per the applicant. · Stairs are barricaded · Facility has no fireplace. · Verification of control of property on file (copy of Grant Deed provided) · All required posting requirements are not posted. See corrections · There are no bodies of water as of this date. Applicant understands 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. (Continue on LIC809C)

SUPERVISOR'S NAME: Gilbert Sena	TELEPHONE: (951) 782-4844
LICENSING EVALUATOR NAME: Nelson Zuniga	TELEPHONE: (951) 782-6634
LICENSING EVALUATOR SIGNATURE:	DATE: 02/24/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2021

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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: SHEN FAMILY CHILD CARE	FACILITY NUMBER: 364845981
	VISIT DATE: 02/24/2021

NARRATIVE

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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.
· Applicant CPR/1st aid expired on 02/08/2022: Health & Safety Training taken on 01/27/2021
· Clean, safe and age appropriate toys.
· There are no toxic plants observed at this time.
· The Applicant was informed of their reporting requirements and is provided with the Regional Office’s Unusual Incident Reporting email mailbox: UnusualIncidentReportsDO09@dss.ca.gov, and UnusualIncidentReportsDO10@dss.ca.gov
· Issued applicant the following: SIDS information and Shaken Baby Syndrome pamphlet – 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-Risk-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
· Applicant will wait until facility opens to determine IMS needs. 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
· 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 02/24/2021 indicate that all adults who require caregiver background checks have received all required clearances or exemptions. (Continue on LIC809C)

SUPERVISOR'S NAME: Gilbert Sena	TELEPHONE: (951) 782-4844
LICENSING EVALUATOR NAME: Nelson Zuniga	TELEPHONE: (951) 782-6634
LICENSING EVALUATOR SIGNATURE:	DATE: 02/24/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2021

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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: SHEN FAMILY CHILD CARE	FACILITY NUMBER: 364845981
	VISIT DATE: 02/24/2021

NARRATIVE

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The following was discussed with the applicant(s):
- SB 277 – Immunizations, Personal Beliefs Exemption, effective January 1, 2016 - it eliminates the exemption from existing specified immunization requirements based upon personal beliefs, and only allows an exemption from future immunization requirements deemed appropriate by the State Department of Public Health or a medical professional for medical reasons.
- AB 290 – Child Nutrition, effective January 1, 2016 - – In accordance with California Health and Safety Code Section 1596.866 - each family day care home licensee who provides care, shall have at least one hour of childhood nutrition training as part of the preventive health practices course or courses.
- SB 792 – Immunization requirements for staff, volunteers, effective September 1, 2016 – In accordance with California Health and Safety Code Section 1597.622 (a)(1)- 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 an influenza vaccination, or they may provide a statement declining the vaccination. If employees/volunteers are receiving the influenza vaccination, they must do so between August 1 and December 1 of each year.
- AB 2231 (2016) – Increased Civil Penalties, effective July 1, 2017 – For failing to correct a violation the civil penalty is increased to $100 per day for EACH violation until corrected; For failing to correct a repeated violation the civil penalty is increased to $250 immediately assessed , and $100 per day afterwards for EACH repeated violation until corrected; For an Immediate Risk violation the civil penalty is increased to $500 immediately assess, and $100 per day for EACH violation after that until corrected; For any repeated Immediate Risk violations the civil penalty is increased to $1,000 immediately assess, and $100 per day afterwards for EACH repeated violation until corrected.
NOTE: Repeat violations are defined as a violation of a previously cited statutory or regulatory Section and/or subsection within 12 months prior.
- AB 2370 – Effective January 1, 2019 – Lead Poisoning – providers are required to provide a lead toxicity prevention handout to parents/guardians of newly enrolled and newly reenrolled children with information on risks and effects of lead poisoning; blood lead testing recommendations and requirements; and options for obtaining blood lead testing, including free and/or discounted testing. There will be a training component of this added to the Preventative Health Training beginning July 1, 2020. (Continue on LIC809C)

SUPERVISOR'S NAME: Gilbert Sena	TELEPHONE: (951) 782-4844
LICENSING EVALUATOR NAME: Nelson Zuniga	TELEPHONE: (951) 782-6634
LICENSING EVALUATOR SIGNATURE:	DATE: 02/24/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2021

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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: SHEN FAMILY CHILD CARE	FACILITY NUMBER: 364845981
	VISIT DATE: 02/24/2021

NARRATIVE

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- 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
- Effective January 1, 2017 – Children under 2 years of age shall ride in a rear-facing car seat unless the child weighs 40 or more pounds OR is 40 or more inches tall. For additional information regarding car seat laws see www.chp.ca.gov
- Pre-Licensing Visit Packet provided (children’s/staff records & posting requirements included)
- Failure to meet the posting requirements shall result in an immediate $100 civil penalty.
- Documentation of fire & earthquake drills to be conducted every six months
- Responsibilities of being a mandated reporter
- Access to forms & Regulations for Family Child Care online at www.ccld.ca.gov
- Responsibility to know the regulations for anyone providing care
- Inaccessibility of hazards must be constantly reassessed depending on the children in care
- Current facility’s phone numbers must always be on file with the licensing office
- Baby walkers, bouncy seats, exert-saucer's and other similar items are prohibited
- The applicant is urged to visit the U.S. Consumer Product Safety Commission web page at
www.cpsc.gov to ensure that equipment purchased for the day care has not been recalled.
- Once licensed, the Notice of Site Visit must be posted at the entrance of the facility for a period of
30 days. If a serious violation is cited, a copy of the licensing report (LIC809/LIC9099) must also
be posted for 30 days. A civil penalty of $100 per violation will be assessed for noncompliance.
v Access to forms & Regulations for Family Child Care Homes online at www.ccld.ca.gov.(Cont LIC809C0

SUPERVISOR'S NAME: Gilbert Sena	TELEPHONE: (951) 782-4844
LICENSING EVALUATOR NAME: Nelson Zuniga	TELEPHONE: (951) 782-6634
LICENSING EVALUATOR SIGNATURE:	DATE: 02/24/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2021

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: SHEN FAMILY CHILD CARE	FACILITY NUMBER: 364845981
	VISIT DATE: 02/24/2021

NARRATIVE

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v 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
v The Duty Officer is available to answer questions Monday – Friday at 1-844-LET-US-NO
(1-844-538-8766).
Before licensure, the following needs to be corrected/completed:
1. All posted requirements are not posted at this time. Applicant will post all required documents and provide pictures.
2. Applicant did not provide a facility sketch of the second floor. Per applicant it will be submitted.
3. In the backyard there is a Cactus plant that will be made inaccessible to children. Applicant will submit pictures of plant.
4. Applicant will be submitting a new LIC279 and LIC279B, family child care application.

Once all corrections have been made, with proof sent to licensing, the application for a Small Family Child Care Home will be submitted for approval with a maximum capacity of 12 or 14 with parent notification. As agreed, upon by the applicant, all corrections are due within 30 days. If not received within 30 days from the date of this report, the application may be withdrawn.
During the exit interview, applicant confirmed that there are no Registered Sex Offenders living in the facility and/or using the facility address for their mailing address.
As a REMINDER: when your child(ren) turn 18 years of age, you MUST SUBMIT an updated LIC279, LIC508 and TB Screen and have your child submit for LIVESCAN background clearance. This also applies to any adult PRIOR to them moving into the home or who currently lives in the home. Also, PRIOR to employment of any adult, you must submit the LIC508, TB screening and obtain a background clearance through LIVESCAN.
LPA generated the report after the Tele-inspection was conducted and emailed the report upon completion. A read receipt was sent and will be used in lieu of the signature for this report. LPA emailed Safe Sleep PIN with the report. The emailed report can be printed and shall be maintained if requested by the public, for 3 years.

SUPERVISOR'S NAME: Gilbert Sena	TELEPHONE: (951) 782-4844
LICENSING EVALUATOR NAME: Nelson Zuniga	TELEPHONE: (951) 782-6634
LICENSING EVALUATOR SIGNATURE:	DATE: 02/24/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2021

LIC809 (FAS) - (06/04)

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