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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020239
Report Date: 02/23/2024
Date Signed: 02/23/2024 11:43:57 AM

Document Has Been Signed on 02/23/2024 11:43 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:CHIU FAMILY CHILD CAREFACILITY NUMBER:
198020239
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 5CENSUS: 5DATE:
02/23/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
11:03 AM
MET WITH:Lihui ChiuTIME COMPLETED:
11:45 AM
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Case Management inspection for capacity increase conducted by Licensing Program Analyst Jennifer Hua. LPA was greeted by Licensee. The purpose of the visit was announced. LPA was guided to a tour by Licensee. This is a 2 story home with 4 bedrooms and 3 bathrooms. There are a total of 3 adults and 0 minor residing in the home. There were five children in care during the inspection. The licensee was observed to be operating within the licensed capacity and is not exceeding the required limitations. Operating hours are M-F 8am - 6pm. Licensee's daughter Kelly Han was present and assisting with the day care. Daughter also helped translate.

All child care areas identified on the Facility Sketch were inspected to include the following:
· Childcare areas: Living room, bathroom in family room (per licensee, will walk with child to restroom), dining area, and fenced backyard maybe use for outdoor play.
· Off limit areas: Kitchen, family room, entire upstairs. Safety gates in place.

All areas used by children were inspected for safety, comfort, cleanliness, telephone, ventilation and heating (central). The licensees state that there are no poisons in the home. The licensees understand that any poisons must be locked with a key or combination lock. Detergents, cleaning compounds, medicines, sharp objects and hazardous items that can pose a danger to children are inaccessible. The valve on the required 2A 10BC fire extinguisher indicates it was fully charged and was purchased on 1/13/23. Per licensee, will purchase a new fire extinguisher this weekend. Smoke and carbon monoxide detector in the hallway were tested and were operable.

Backyard is adequately fenced and there is a swimming pool/jacuzzi on the premise. The pool/jacuuzi is surrounded by block wall on one side. On the opposite side, 5 feet iron fencing with 1 gate that opens away from pool, self close and self latch on top of gate. The pool/jacuzzi is surrounded by fencing/block wall as required and meet Title 22 Regulations at this time..
SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Jennifer Hua
LICENSING EVALUATOR SIGNATURE: DATE: 02/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/23/2024
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: CHIU FAMILY CHILD CARE
FACILITY NUMBER: 198020239
VISIT DATE: 02/23/2024
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Per licensee, there are no weapon on the premise. There are no pets. There are age appropriate toys, equipment were observed for children. Posting requirements were observed to be posted at the time of inspection.

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

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.

All adults present have obtained a criminal record clearance. The licensee has proof of current pediatric first aid and CPR (expires: 10/21/2025). Licensee has completed required mandated reporter training on 10/16/22. Roster reviewed and is complete Drills were conducted on 1/17/24 as noted on drill log.

Fire Clearance has been received.

Capacity increase will be approved.

No deficiencies cited. An exit interview conducted, copy of the report given. Notice of Site Visit form was provided and shall be posted for 30 days in an area accessible for review.

SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Jennifer Hua
LICENSING EVALUATOR SIGNATURE:

DATE: 02/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2024
LIC809 (FAS) - (06/04)
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