198018313-7-30-2021-33-CC-BBAT-C5EQRL-20210730122408

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198018313
Report Date: 07/30/2021
Date Signed: 07/30/2021 12:24:20 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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	YANG FAMILY CHILD CARE		FACILITY NUMBER:	198018313
ADMINISTRATOR:	YANG, XIAO		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(626) 646-8267
CITY:	ROSEMEAD	STATE: CA	ZIP CODE:	91770
CAPACITY:	14	CENSUS:	DATE:	07/30/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:15 AM
MET WITH:	Xiao and Frank Yang, Licensee		TIME COMPLETED:	12:30 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	Unannounced required annual inspection conducted by Licensing Program Analyst (LPA) Bardo Baluyot. LPA met licensee, Xiao Yang and her husband Frank who helped translate. Licensee guided analyst on a tour of the facility. Licensee is Cantonese speaking only. Visit was conducted in English. LPA observed five children present all above the age of 24 months. All children were wearing face masks. This is a one story home which consists of 4 bedrooms, 2 bathrooms, Child care areas inspected are living room, bathroom. Per licensee, areas off limits to children and parents include: 3 bedroom and 1 bathroom , kitchen, and outdoors. Licensee states that total 2 adults and 1 minor live in the home. All areas used by children were inspected. The following was observed during this visit. Detergents, cleaning compounds, medications, and other items which could pose a danger to children are inaccessible to children. Licensee states that there are no poisons in the home. The home was observed to have heating and ventilation for safety and comfort. The valve on the required 2A 10BC fire extinguisher indicates fully charged and extinguisher was purchased on 4/12/2021 as noted on the receipt. Smoke detector were tested, and observed to be working. Carbon monoxide detector is available and operational. The home was observed to be clean and orderly.

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3351
LICENSING EVALUATOR NAME: Bardo Baluyot	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 07/30/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2021

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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: YANG FAMILY CHILD CARE	FACILITY NUMBER: 198018313
	VISIT DATE: 07/30/2021

NARRATIVE

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There are no stairs in the home.

There is a working telephone in the home

The capacity specified on the license shall be the maximum number of children for whom care can be provided. The licensee is operating within the license capacity limitations. .

All homes shall conduct fire and disaster drills at least once every six months, and document the date and time of each drill. Last drills documented was on 06/09/2021.

All individuals present in the home have obtained a criminal record clearance.

The licensee is current in Pediatric First Aid and CPR that will expire on 6/19/2023.

There are no firearms, weapons, bodies of water or pets on the premises.

Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted

Individuals who are 18 years of age or older living in the home must obtain a criminal record clearance. Individuals within one month of their 18th birthday must be fingerprinted immediately. Failure to obtain a criminal record background check clearances prior to initial presence in the home will result in an immediate $100.00 dollar or more per day Civil Penalty.

No smoking, No infant walkers, No Johnny jumpers, No saucer chairs, No trampolines and any other item that falls into that category are not permitted in the facility.

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3351
LICENSING EVALUATOR NAME: Bardo Baluyot	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 07/30/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2021

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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: YANG FAMILY CHILD CARE	FACILITY NUMBER: 198018313
	VISIT DATE: 07/30/2021

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Children’s Records were reviewed for completeness; Inspection of required forms was made. A Child Care Provider's Guide to Safe Sleep handout was provided and discussed. LPA observed affidavit for liability insurance form in children's files. Licensee was informed to complete the Mandated Reporter Training on department website at http://www.mandatedreporterca.com/ once training is available in her language. LPA explained details of mandated reporting to licensee's husband and both acknowledged that they had signed

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) 514-0388 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

LPA advised the licensee how to access forms, regulations and quarterly updates on line at: www.ccld.ca.gov.

No deficiency cited.

Exit interview was conducted with Xiao and Frank Yang, licensee, including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role. Notice of Site Visit form was provided and explained. The notice shall be posted for 30 days or a civil penalty of $100 shall be assessed.

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END OF REPORT

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3351
LICENSING EVALUATOR NAME: Bardo Baluyot	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 07/30/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2021

LIC809 (FAS) - (06/04)

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