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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376621835
Report Date: 02/16/2022
Date Signed: 02/16/2022 02:42:50 PM


Document Has Been Signed on 02/16/2022 02:42 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
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108



FACILITY NAME:LI, MIMI FAMILY CHILD CAREFACILITY NUMBER:
376621835
ADMINISTRATOR:MIMI LIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(858) 349-2898
CITY:SAN DIEGOSTATE: CAZIP CODE:
92129
CAPACITY:14CENSUS: 12DATE:
02/16/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Mimi Li TIME COMPLETED:
03:00 PM
NARRATIVE
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On 2/16/22 at 10:45 am Licensing Program Analyst (LPA) Annette Sutherland arrived at the facility to conduct an unannounced annual inspection. LPA was granted entry by Licensee Mimi Le and helper Beechan Lee. Beechan Lee assisted with translation to Chinese. Licensee was provided the Inspection Checklist (LIC 126) upon entry to the facility. Also present was Guiqin Li and unclear adult Yali Huang. The two -story home was toured and inspected to ensure an environment safe for the care and supervision of children. There are 12 day-care children present in the home.

Licensee has provided adequate space for the children to eat, sleep and play within the home. Areas used for childcare include 3 downstairs rooms, and bathroom#1 and backyard. Off Limits areas include entire 2nd floor, bathroom #2, Kitchen , Dining room, Living room and garage. These areas are inaccessible through use of safety gates. There is a working phone at the facility. The fire extinguisher, carbon monoxide detector, and smoke detector meet requirements and are operational. All hazardous items were secured out of reach of children in off limit areas, this includes detergents, cleaning compounds, medications and other items which could pose a danger to children. Inaccessibility of hazards must be constantly reassessed depending on the children in care. There is a properly barricaded fireplace on the first floor and an additional fireplace located in off limit area in family room.

Continued on LIC 809 c
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Annette SutherlandTELEPHONE: (619) 629-8751
LICENSING EVALUATOR SIGNATURE:
DATE: 02/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/16/2022
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: LI, MIMI FAMILY CHILD CARE
FACILITY NUMBER: 376621835
VISIT DATE: 02/16/2022
NARRATIVE
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Verification of control of property is on file. Licensee’s husband owns the home. Facility Sketch, Emergency Disaster Plan & Notification of Parent’s Rights poster are not posted. Pediatric CPR and First Aid Card for Mimi Li expire on June 2022 and November 2023 for Beechan Lee . Licensee meets immunization requirements. Mandated Reporter training was not taken due to language barrier for Mimi Li & Guiqin Li (Chinese). Mandated reporter training has not been taken by helper Beechan Lee. Licensee has conducted disaster drills but has not logged them. Children’s records were reviewed to review. Licensee does not have a completed roster.

There are no bodies of water. Licensee understands all bodies of water including ponds, above ground pools & spas, in-ground pools & 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.

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. The home is clean and orderly, with heating and ventilation for safety and comfort. Safe and age appropriate toys and equipment are present for both indoor and outdoor activities. Licensee stated that she bring the children to the outdoor grass area within the gated complex.

Licensee was reminded that all adults 18 and over living or working in the home, 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 inspection consisted of reviews of the following domains: Physical Plant, Care and Supervision, Facility Administration, Records, Staffing Ratio and Capacity, and Personal Rights.

Access to forms & Regulations for Family Child Care are online at www.ccld.ca.gov. Please note it is you Responsibility to know the regulations for anyone providing care. The Duty Officer is available to answer questions Monday – Friday at (619) 767-2248 for any Unusual Incident Reporting.

Continues LIC 809C

SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Annette SutherlandTELEPHONE: (619) 629-8751
LICENSING EVALUATOR SIGNATURE:

DATE: 02/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/16/2022
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: LI, MIMI FAMILY CHILD CARE
FACILITY NUMBER: 376621835
VISIT DATE: 02/16/2022
NARRATIVE
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LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep web page 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.
Provider is hereby reminded of the following: Report suspected child abuse and neglect, maintain children’s records according to regulation, post all required forms, ensure that all adults living or working in the home have criminal background clearances to avoid civil penalties associated with this requirement; corporal punishment, smoking, exersaucers, bouncy seats, walkers, and jumpers are not allowed in day care. All equipment that is used should be used only as intended by the manufacturer. LPAs and Licensee discussed California Megan's Law and LPAs provided: www.meganslaw.ca.gov.
LPA reviewed Covid-19 guidelines with Licensee and provided Covid-19 resources. Please subscribe to 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.

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

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.

Deficiencies are cited. See LIC 809 D and Technical Violations.

Exit interview conducted and report was reviewed with the licensee. A notice of site visit was given and must remain posted for 30 days.
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Annette SutherlandTELEPHONE: (619) 629-8751
LICENSING EVALUATOR SIGNATURE:

DATE: 02/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/16/2022
LIC809 (FAS) - (06/04)
Page: 2 of 7
Document Has Been Signed on 02/16/2022 02:42 PM - It Cannot Be Edited

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: LI, MIMI FAMILY CHILD CARE

FACILITY NUMBER: 376621835

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 02/16/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview, the licensee helper did not comply with the section cited above in which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/16/2022
Plan of Correction
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Licensee will provide copy of helper Mandated Reporter training certificate.
Type B
Section Cited
CCR
102416.1(a)
Personnel Records
(a) Personnel records shall be maintained on each employee and shall contain the following information:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/28/2022
Plan of Correction
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Licnesee will provide proof of helper's file by

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: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Annette SutherlandTELEPHONE: (619) 629-8751
LICENSING EVALUATOR SIGNATURE:
DATE: 02/16/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/16/2022
LIC809 (FAS) - (06/04)
Page: 4 of 7


Document Has Been Signed on 02/16/2022 02:42 PM - It Cannot Be Edited

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: LI, MIMI FAMILY CHILD CARE

FACILITY NUMBER: 376621835

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 02/16/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102370(d)(1)

102370(d)(1) Criminal Record Clearance: All individuals subject to a criminal record review…shall prior to working, residing in a licensed facility…Obtain a California clearance...as required by the Department. This requirement was not met as evidenced by:


This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, it was determined that Yali Huang has been working in the home without proper fingerprint clearance which poses an immediate health and safety risk to persons in care.
POC Due Date: 03/16/2022
Plan of Correction
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Licensee understands that this individual cannot work at the facility until they have a criminal record clearance and have been associated to facility. Licensee will provide written statement to confirm this by 2/17/22.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Annette SutherlandTELEPHONE: (619) 629-8751
LICENSING EVALUATOR SIGNATURE:
DATE: 02/16/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/16/2022
LIC809 (FAS) - (06/04)
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