198020766-6-12-2024-33-CC-CTUA-D66S83-20240612133827

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198020766
Report Date: 06/12/2024
Date Signed: 06/12/2024 01:38:49 PM

Document Has Been Signed on 06/12/2024 01:38 PM - 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:	ZHOU FAMILY CHILD CARE		FACILITY NUMBER:	198020766
ADMINISTRATOR/ DIRECTOR:	FENG XIU		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(213) 392-2100
CITY:	LA PUENTE	STATE: CA	ZIP CODE:	91744
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 8	CENSUS: 6	DATE:	06/12/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:15 AM
MET WITH:	Feng Xiu Zhou		TIME VISIT/ INSPECTION COMPLETED:	02:00 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	On 6/12/2024 at 9:15 am, Licensing Program Analyst (LPA), Carolyn Tuba conducted an unannounced annual inspection for the above facility. This is a Large Family childcare home. A Covid risk assessment was conducted. LPA met with Licensee, Feng Xiu Zhou who guided LPA on a tour and observed 6 children in care and an additional adult who is the Licensee’s spouse and assist with the children. Licensee stated that she has 8 children currently enrolled. During the course of the visit LPA utilized support staff to translate in the Licensee’s native language of Mandarin, as well as Licensee’s son. A facility roster was available. Per Licensee, operating hours are from Monday - Saturday 8:30 am – 6:00 pm and the age group she currently works with are 15 months-5 years old. The licensee is part of Options food program and provides lunch, PM snack and dinner to the children in care. This is a one-story house which consists of a living room, family room (play area), kitchen, breakfast nook, garage, front yard, back yard, side yard, 3 bedrooms and 2 bathrooms. Child Care areas were inspected and are used by the children as follows: the living room, family room (play area) one bedroom for infant to sleep, bathroom, side yard, and backyard. The sofa in the living room is utilized for an ill child. Per Licensee, areas off limits to children and parents include 2 bedrooms, 1-bathroom, front yard, kitchen and garage. The licensee states that there are 3 adults including herself and one (1) minor currently live in the home. Per Licensee, her spouse assists with the children. All adults present in the home have obtained a criminal record clearance or exemption prior to working, residing, or volunteering in the licensed childcare home. 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 Page 1 of 4

SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Carolyn Tuba
LICENSING EVALUATOR SIGNATURE:	DATE: 06/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/12/2024

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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Document Has Been Signed on 06/12/2024 01:38 PM - It Cannot Be Edited

Created By: Carolyn Tuba On 06/12/2024 at 12:30 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: ZHOU FAMILY CHILD CARE	FACILITY NUMBER: 198020766
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/12/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102417(g)(1)

Operation of A Family Child Care Home

(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (1) Fireplaces and open face heaters shall be screened to prevent access by children. The home shall contain a fire extinguisher and smoke detector device which meet standards established by the State Fire Marshall. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above in the Fire Extinguisher was last serviced on 8/23/2023 which falls within the 1 year guideline but the arrow on the gage is pointing to empty which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 06/12/2024
	Plan of Correction
1 2 3 4	Licensee will be either servicing or purchasing a new fire exstinguisher.

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in not being able to provide proof of the Mandated Reporting training certificate for Licensee's spouse who assists which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 06/26/2024
	Plan of Correction
1 2 3 4	Per Licensee her spouse will be taking the training and providing proof of the Mandated Reporting Training Certificate.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME:

Ana Chico

LICENSING EVALUATOR NAME:

Carolyn Tuba

LICENSING EVALUATOR SIGNATURE:

DATE: 06/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/12/2024

LIC809 (FAS) - (06/04)

Page: 2 of 5

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: ZHOU FAMILY CHILD CARE	FACILITY NUMBER: 198020766
	VISIT DATE: 06/12/2024

NARRATIVE

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minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA observed a baby gate between the kitchen and living room, also the hallway leading into the bedrooms and bathroom, as well as the living room leading down into the family room (play area), as there are a few steps that lead down.

The home was inspected for safety, comfort, cleanliness, ventilation, and telephone service.
Fire and safety drills must be performed every 6 months and documented for review by the Department. Licensee conducted an Emergency Drill in May 2024. No one smokes in the at family childcare home.

In the absence of the licensee a qualified adult must be present supervising the children; a qualified adult is an individual who has a valid and current Pediatric First Aid and CPR training, Immunization's (TDAP, MMR, TB, Influenza), mandated reporter training and a valid criminal record clearance associated to the facility license. The licensee provided proof and will expire, April 2026. Licensee’s spouse who works with the children did not have proof of Mandated Reporting Training. LPA informed the Licensee that even though English is not the native language of her spouse the training is available in both Mandarin and Cantonese offered on the Department’s web site: http://www.mandatedreporterca.com/training.htm. LPA advised that Mandated Reporting training needs to be conducted every 2 years. The licensee and other personnel have completed training on preventive health practices including Pediatric First Aid and CPR. The licensee, and her spouse currently have Pediatric First Aid and CPR which expires on 6/17/2025, which is EMS approved.

Detergents, cleaning compounds, medications, and other items, which could pose a danger, were determined to be inaccessible to children in care during this inspection. Medication is kept in the off-limit area of the bedroom. Cleaning supplies are kept on high shelves out of reach of children.

LPA observed the required 2:A-10:B-C fire extinguisher and tag stated the last time it was inspected on August 23, 2023, which falls within the 1 year guideline but the arrow on the gage is pointing to empty. LPA advised that per State Fire Marshall standards, fire extinguishers shall be service annually. Licensee states that she will be taking it in to be serviced or purchase a new extinguisher. The smoke detector and carbon monoxide detector were tested and operating correctly. Per Licensee, there are no weapons, firearms, or bodies of water on the premises. Per Licensee there are no pets. LPA did not observed any at the time of visit.
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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Carolyn Tuba
LICENSING EVALUATOR SIGNATURE:	DATE: 06/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/12/2024

LIC809 (FAS) - (06/04)

Page: 3 of 5

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: ZHOU FAMILY CHILD CARE	FACILITY NUMBER: 198020766
	VISIT DATE: 06/12/2024

NARRATIVE

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LPA advised the Licensee with regards to safe sleep and that infants under 24 months shall be checked on every 15 minutes and the time of each 15-minute check shall be documented with child’s name, date and initials of the person who checked on the child. LPA provided Licensee a booklet on Safe Sleep. The LIC 9227 Individual Infant Sleeping Plan shall be completed for each infant up to 12 months of age. LPA advised Licensee the Provider Information Notice (PIN) 20-24 CCP: Recently Approved Safe Sleep Regulations in Effect. Per Licensee children are checked and documentation was provided.

The licensee is observed to be operating within the license capacity limitations. LPA did not observe any children left in parked vehicles. Car seats shall only be used for transportation. LPA did not observe any children sleeping in car seats. The Licensee was reminded to utilize play yards, cribs, and highchairs for what they are intended for and not leave children in them for any other reason.

Currently, children are using the back yard for outdoor play time. The outdoor play area was observed to be enclosed with a plastic fence measuring at least 6 feet high. There is an iron gate surrounding the play area where children play outside and lattice is used to keep children out of the garden area. LPA observed that the outdoor yard has toys, bikes, play equipment and plastic cars, as well as other materials for children to play with. There is shade structure over the play equipment.

Children and Staff records must be maintained and updated as needed and must be available for review by the Department. If Children and Staff leave the day care all records must be maintained for 3 years after leaving. LPA discussed with Licensee about Infant Sleep Plan for children under 12 months of age.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at
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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Carolyn Tuba
LICENSING EVALUATOR SIGNATURE:	DATE: 06/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/12/2024

LIC809 (FAS) - (06/04)

Page: 4 of 5

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: ZHOU FAMILY CHILD CARE	FACILITY NUMBER: 198020766
	VISIT DATE: 06/12/2024

NARRATIVE

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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.

According to Licensee there are currently no children taking medications. Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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 Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, the Licensee, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Licensee, Feng Xiu Zhou.
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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Carolyn Tuba
LICENSING EVALUATOR SIGNATURE:	DATE: 06/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/12/2024

LIC809 (FAS) - (06/04)

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