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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376626085
Report Date: 11/06/2019
Date Signed: 11/06/2019 11:29:46 AM

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:JIANG, MEIGE FAMILY CHILD CAREFACILITY NUMBER:
376626085
ADMINISTRATOR:MEIGE JIANGFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 888-3706
CITY:SAN DIEGOSTATE: CAZIP CODE:
92127
CAPACITY:14CENSUS: 11DATE:
11/06/2019
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
09:18 AM
MET WITH:Meige Jiang TIME COMPLETED:
11:40 AM
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Licensing Program Analysts (LPAs) Rajani Goudreau and Martha Malane conducted an unannounced plan of correction visit to ensure deficiency cited on 10/29/19 under section 1597.465(b) has been cleared. Upon arrival, LPAs met with licensee, Meige Jiang and proceeded to tour the facility. During today's visit there were 11 children in care including four infants. LPAs observed one staff and licensees spouse present in facility at time of tour.

Staff #1 (S1) has no child abuse index clearance, per review of LIS. However, S1 is partially cleared and associated to facility. LPA reviewed LIC9163 - Request for Live Scan for S1 dated 10/04/19. Criminal record clearance for S1 will be looked into further by LPA. LPA informed licensee of the clearance requirements. Licensee indicated S1 will not work in facility until she is cleared through child abuse index clearance. In addition, LPAs observed licensing reports citing type A deficiencies and LIC9213 - Notice of Site Visit dated 10/29/19 posted. LPAs reviewed children's records to ensure Acknowledgment of Receipt of Licensing Reports (LIC9224) was signed and placed in the children's files. In addition, licensee submitted plan of correction verifications for deficiency under section 1597.465(b). Deficiency cleared during today's visit. Cleared plan of correction letter generated and provided to licensee.

LPA delivered an amended report originally created on 10/29/19.

No deficiencies issued during today's visit. LPA conducted an exit interview with licensee. LPA informed licensee LIC9213-Notice of Site Visit must be posted for 30 days from today's date. LPA observed LIC9213 posted prior to exiting facility.
SUPERVISOR'S NAME: Jason GarayTELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Rajani GoudreauTELEPHONE: (619) 767-2215
LICENSING EVALUATOR SIGNATURE:

DATE: 11/06/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2019
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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