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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198021217
Report Date: 04/22/2026
Date Signed: 04/22/2026 04:39:20 PM

Document Has Been Signed on 04/22/2026 04:39 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:CHAO FAMILY CHILD CAREFACILITY NUMBER:
198021217
ADMINISTRATOR/
DIRECTOR:		CHAO, HSIAOHSUANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(858) 699-3893
CITY:TEMPLE CITYSTATE: CAZIP CODE:
91780
CAPACITY: 14TOTAL ENROLLED CHILDREN: 13CENSUS: 13DATE:
04/22/2026
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:37 PM
MET WITH:Licensee Shelly ChaoTIME VISIT/
INSPECTION COMPLETED:
05:15 PM
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At 2:15pm, Licensing Program Analyst (LPA) Stephanie Li conducted an unannounced annual inspection to the above facility. A risk assessment was conducted upon entry. LPA met with Licensee Shelly Chao, who led LPA on a tour of the facility. There are currently 13 children enrolled. There was 2 adult and 13 children present upon arrival. Facility capacity is in compliance for a Large Family Child Care Home. Hours of operation are Monday-Friday, currently 8:00am-5:00pm.

This is a one story home, which consists of 3 bedrooms, 2 bathroom, kitchen, living room (day care and nap area), dining room, garage, back patio and front play yard. On limits to children are living room (daycare area), 1 bedroom, 1 bathroom, and front yard. Per licensee, areas off limits to children and parents include: 2 bedrooms, 1 bathroom, dining room, kitchen, back patio and garage. The LPA toured all areas used by children during this visit.

All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. There is central AC and heater. There is telephone service via cell phone that stays at the facility during operation hours. Licensee's own infant was present and was picked up by father during visit. LPA advised that her own infant throws her out of capacity, as there were 3 infants present. LPA reviewed capacity worksheet poster with licensee. Licensee understands infant ratio and capacity. Capacity worksheet was emailed to licensee.

LPA observed that the following required postings were up: Facility License, Publication (PUB) 394- Notification of Parent Rights, LIC 610- Facility Disaster Plan, and Earthquake preparedness. All homes shall conduct fire and disaster drills at least once every six months, and document the date and time of each drill. Last drill was conducted in 4/06/2026. There is a fireplace boarded up and not assessable. pg. 1 of 3

NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Stephanie Li
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/22/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/22/2026
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: CHAO FAMILY CHILD CARE
FACILITY NUMBER: 198021217
VISIT DATE: 04/22/2026
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There are toys, equipment and learning materials available for children. There are mats available for each child to nap. First aid kit is available. Drinking water is available through filtered fountain spout. Licensee provides morning snack, lunch, and afternoon snack. Cleaning compounds are stored at top of off limits kitchen sink. LPA observed all off limits area are made off limits with baby gates. Licensing staff reminded licensee smoking is not allowed in a family child care home. The restroom that children use was observed to be safe and sanitary.

LPA observed the required fire extinguisher 2A 10BC, last purchased on 11/27/25. Per State Fire Marshall standards, fire extinguishers shall be serviced or purchased annually. Smoke detector was tested and operable. Carbon monoxide detector was not present in the home so unavailable to test. A citation is being issued, see page LIC809D.

LPA observed the front yard area. The outdoor play area was observed to be fenced. There are age appropriate materials for children to use. There are 2 bunnies in a bunny kennel in the front yard. There is monkey bars, slides, little cars and toys for children to play.



Adult and children’s records were reviewed and observed. The licensee has completed Pediatric First Aid and CPR exp 07/29/25. Per licensee, she renewed CPR training and the online RED CROSS portal shows card as active. Licensee has not renewed Mandated Reporter AB 1207 Child Care Training certificate that expired in 2024. Per licensee, she was not aware that is was renewable every 2 years. LPA advised that all staff must renew mandated reporter certificates every 2 years. No notes were observed regarding mandated reporter in prior visits. Technical violations are being issued for CPR documenting and renewal of mandated reporter certificates.

Incidental Medical Services (IMS) is not currently being provided at this time. 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 child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California. pg. 2 of 3
NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Stephanie Li
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/22/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2026
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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: CHAO FAMILY CHILD CARE
FACILITY NUMBER: 198021217
VISIT DATE: 04/22/2026
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LPA advised the licensee to access forms, regulations and quarterly updates on line at: www.ccld.ca.gov.
Language selection is on the top right white box of the web page.

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/process.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/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.



Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Currently, the licensee is in compliance with California Title 22 Regulations. There are citations being issued today. Technical violations are being issued. Citations and Technical violations need to be cleared to protect the health and safety of children in care.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted, report reviewed was reviewed with Licensee Shelly Chao.

pg. 3 of 3

NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Stephanie Li
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/22/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2026
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 04/22/2026 04:39 PM - It Cannot Be Edited


Created By: Stephanie Li On 04/22/2026 at 04:15 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: CHAO FAMILY CHILD CARE
FACILITY NUMBER: 198021217

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/22/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.543
Licensure Requirements
Every family day care home for children shall have one or more carbon monoxide detectors in the facility that meet the standards established in Chapter 8 (commencing with Section 13260) of Part 2 Division 12. The department shall account for the presence of these detectors during inspections.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above as carbon monoxide detector was not present in the home, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/24/2026
Plan of Correction
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Per licensee, carbon monoxide detector was ordered during visit. Per Licensee, it arrives tomorrow and she will install it and send video of sounding alarm to LPA S Li phone by Friday 4/24/26.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Christina Gabelman
NAME OF LICENSING PROGRAM MANAGER:
Stephanie Li
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 04/22/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/22/2026


LIC809 (FAS) - (06/04)
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