198019607-4-13-2022-33-CC-JMOA-CDFMNR-20220413094559

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198019607
Report Date: 04/13/2022
Date Signed: 04/13/2022 09:46:43 AM

Document Has Been Signed on 04/13/2022 09:46 AM - 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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	ZHANG & WANG FAMILY CHILD CARE		FACILITY NUMBER:	198019607
ADMINISTRATOR:	LEI ZHANG		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(626) 802-7173
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90032
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 8	CENSUS: 3	DATE:	04/13/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:35 AM
MET WITH:	Lei Zhang		TIME COMPLETED:	10:05 AM

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	Licensing Program Analyst (LPA) Judy Mora conducted an unannounced annual required inspection at the above facility on 04/13/22 at 08:35 AM. LPA met with Lei Zhang, Licensee who guided analyst on a tour of the facility. The Licensee's parents, Lili Wang and Jinsheng Zhang were present in the home. There were three children present during this inspection. Facility capacity is in compliance for a small Family Child Care Home. Per Licensee hours of operation are Mon-Fri 8:00 AM - 6:00 PM. Family members residing in the home are 3 adults (criminal record clearances on file) and 1 child. This is a two story home which consists of 5 bedrooms, 3 bathrooms, kitchen, dining room, living room, backyard and front yard (fenced). Stairs leading to the second floor were observed to be barricaded and inaccessible. The children use one bathroom, the living room, dining room and two bedrooms. Areas accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating. There is a fireplace in the living room which is inaccessible. The backyard is used for outside play. The outdoor play area was observed to be fenced. LPA observed that the outdoor yard has toys and other materials for children to play with. LPA did not observe any objects that could be hazardous to children in care. There are toys and other age appropriate material available for children. There is a working telephone service maintained in the home. Detergents, cleaning compounds, medications, and other items which can pose a danger to children are inaccessible in all areas of the home. All food items are prepared by the Licensee. Smoke and carbon monoxide detectors were tested and are operable. Fire extinguisher indicates fully charged, however last service was 06/2020. LPA observed the following required posted documentation in the main entry way of the facility: Facility License, Publication (PUB) 394- Notification of Parent Rights and Licensing Form (LIC) 9148- Earthquake Preparedness form. LPA reviewed facility records for LIC 9040- Facility Roster, LIC 610- Facility Disaster Plan and Disaster drill log, last drill documented was 01/28/2022. Licensee states that there are currently 08 children enrolled, children's roster was reviewed and is current. *REPORT CONTINUES ON NEXT PAGE

SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Judy Mora
LICENSING EVALUATOR SIGNATURE:	DATE: 04/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2022

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

FACILITY NAME: ZHANG & WANG FAMILY CHILD CARE	FACILITY NUMBER: 198019607
	VISIT DATE: 04/13/2022

NARRATIVE

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Licensee states that there are no poisons stored in the home and understands that all poisons must be locked, not only inaccessible to children. Isolation area for sick children waiting to be picked up is near the stairwell, away from the other children. Per Licensee there are no firearms or weapons stored in the home.

Infant Care: Per Licensee, she is currently caring for 2 infants under 12 months. LPA informed licensee of the new Safe sleep regulations, including LIC 9227 Infant Sleep Plan for infants under 12 months, 15-minute sleep check documentation for infants 0-24 months. LPA observed play yards to be in compliance with Title 22 regulations.

Children’s records were reviewed for (LIC) 282- Affidavit Regarding Liability Insurance, Immunization's Records, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights, LIC 9227- Infant sleep form (0-12 months, and documentation of 15-minute Infant Sleep Check (0-24 months). LPA observed C3 & C4 to not have Immunization Record's on file. Licensee will obtain copies and place them in children's files.

Staff records were reviewed for approved Pediatric First Aid and CPR certification, expires 01/2024, LIC 508- Criminal Record Statement, Proof of immunization's against measles, pertussis and influenza or influenza declination, TB clearance or risk assessment, LIC 9108- Statement Acknowledging Requirement to Report Child Abuse and current Mandated Reporter Training Certificate, completed 03/02/2022. Licensee, Lili Wang's Pediatric First Aid & CPR expires 01/24.

During inspection all children were observed to be treated with dignity and respect, they were observed to be receiving safe, healthful and comfortable accommodations, furnishings and equipment, and free from corporal and/or unusual punishment.

LPA observed that licensee is implementing COVID-19 precautions and procedures.

*REPORT CONTINUES ON NEXT PAGE

SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Judy Mora
LICENSING EVALUATOR SIGNATURE:	DATE: 04/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2022

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

FACILITY NAME: ZHANG & WANG FAMILY CHILD CARE	FACILITY NUMBER: 198019607
	VISIT DATE: 04/13/2022

NARRATIVE

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Incidental Medical Services (IMS):
Incidental Medical Services (IMS) policy was discussed. Per Licensee, there are no children on medications. 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 Center and the ADA, available at: http://www.ada.gov/childqanda.htm

Based on the LPA's observations and records review no deficiencies will be cited today 04/13/22.

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.

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.

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.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the Licensee, Lei Zhang.

SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Judy Mora
LICENSING EVALUATOR SIGNATURE:	DATE: 04/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2022

LIC809 (FAS) - (06/04)

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