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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020320
Report Date: 01/26/2024
Date Signed: 01/26/2024 11:59:43 AM

Document Has Been Signed on 01/26/2024 11:59 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:YAN FAMILY CHILD CAREFACILITY NUMBER:
198020320
ADMINISTRATOR:YAN H. YANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 673-8863
CITY:SOUTH EL MONTESTATE: CAZIP CODE:
91733
CAPACITY: 14TOTAL ENROLLED CHILDREN: 11CENSUS: 11DATE:
01/26/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Yan Yan TIME COMPLETED:
12:15 PM
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Licensing Program Analysts (LPA’s) Roxana Lopez and Saul Valenzuela conducted an unannounced poc (plan of correction) inspection to insured that the Type A and Type B deficiencies cited on 12/04/2023 have been cleared. LPA’s met with Yan Yan , licensee who guided analysts on a tour of the facility. There were 11 children present during this inspection. The following was observed:

- Fire extinguisher was last serviced on 12/5/2023

- Un- fingerprinted Joshua Polonco was not present in the home. He is going through fingerprint process.

- LIC 9224 Acknowledgment Form was observed to be on file

LPA’s advised the licensee how to access forms, regulations and quarterly updates on the Child Care Licensing Website at: www.ccld.ca.gov.

LPA’s cleared deficiency on this date and provided a copy. LPA’s issued POC clearance letter during the visit.

At this time, the licensee is in compliance with California Code of Regulations Title 22. Therefore, no deficiencies are being cited.

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 Licensee, Yan Yan.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Roxana Lopez
LICENSING EVALUATOR SIGNATURE: DATE: 01/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/26/2024
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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