376100565-12-2-2020-51-CC-SSIO-BVX363-20201202165740

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376100565
Report Date: 11/19/2020
Date Signed: 12/02/2020 04:57:51 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME:	ZHONG, CHENG FAMILY CHILD CARE		FACILITY NUMBER:	376100565
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 1	DATE:	11/19/2020
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Cheng Zhong		TIME COMPLETED:	04:00 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 11/19/2020 at 2pm, Licensing Program Analyst (LPA), Selina Siao conducted a scheduled pre licensing tele inspection via zoom due to COVID-19 with applicant. The 4 bedroom, 3 bath, 2 story house was toured and inspected to ensure an environment safe for the care and supervision of children. The home has a fully charged fire extinguisher size 2A10BC, smoke and carbon detector that meet requirements and are operational. All hazardous items were latched/locked and secured out of reach of children during the inspection. Applicant stated that the home doesn't have any weapon or bodies of water. Applicant has an EMSA approved pediatric CPR and First Aid card that are current due to expire on 11/17/21 and she completed the 8 hours preventative health practice course that includes the lead poisoning prevention on 09/13/2020. Applicant also completed the online mandated child abuse training on 02/02/2020. A review of the application and records on this date indicates that applicant and her husband are the current adult residents at the home has the required background clearances. Applicant and her husband both have TB and required immunizations. Applicant and her husband owns the property and has provided a copy of the grant deed as proof. Applicant will be using the following areas for childcare: living room, dining room, kitchen and downstairs bathroom. Off limit areas includes downstairs bedroom, garage and all of upstairs. There is a safety gate at the bottom of the stairs to prevent access. Outdoor area will be the fenced backyard and visual supervision is required when children are outside. Applicant was reminded of requirements for children’s records, facility roster, child abuse and unusual incident reporting, immunizations, adults living or working in the home and associated civil penalties of $100 per day, car seat law, shaken baby syndrome and SIDS. Applicant was reminded that corporal punishment, smoking, baby walkers, exersaucers, bouncy seats and baby jumpers are not allowed in day care. The ABC’S of Safe Sleep: Sleep is Safest: Alone, on their Back in an empty Crib on a firm mattress.

SUPERVISOR'S NAME: Monica Cuddy	TELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Selina Siao	TELEPHONE: (619) 767-2217
LICENSING EVALUATOR SIGNATURE:	DATE: 11/19/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2020

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, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: ZHONG, CHENG FAMILY CHILD CARE	FACILITY NUMBER: 376100565
	VISIT DATE: 11/19/2020

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

Applicant shall comply with all regulations and laws governing family childcare homes and be financially secure to operate a family childcare home for children.

Child Care Providers can now sign up for Quarterly Updates and PINS through the DSS website at www.ccld.ca.gov . LPA discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov.

Applicant has completed and submitted the family childcare self-certificate checklist and COVID-19 self assessment guide.

The following corrections are needed within 10 days prior to granting a license:

A latch for the off limit downstairs bedroom
Outlet covers for the day care areas

Analyst read the report to applicant during the tele-inspection. A copy of the report will be e-mailed to applicant and she was advised that acknowledgement of the receipt of the report is to be received from applicant within twenty-four hours.

SUPERVISOR'S NAME: Monica Cuddy	TELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Selina Siao	TELEPHONE: (619) 767-2217
LICENSING EVALUATOR SIGNATURE:	DATE: 11/19/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2020

LIC809 (FAS) - (06/04)

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