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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198021382
Report Date: 07/02/2024
Date Signed: 07/02/2024 03:11:28 PM

Document Has Been Signed on 07/02/2024 03:11 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:SITU FAMILY CHILD CAREFACILITY NUMBER:
198021382
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 4CENSUS: 3DATE:
07/02/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:30 PM
MET WITH:Ruichan Situ, Licensee. TIME VISIT/
INSPECTION COMPLETED:
03:20 PM
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Licensing Program Analyst (LPA) Roxana Lopez conducted an unannounced Case Management inspection due to incident that was reported to the Department on June 27thh, 2024. LPA met with Licensee Ruichan Situ who guided LPA on a tour of the facility. Census was taken.

On June 27th, 2024, an incident was self-reported to the Department in person by the licensee who reported that child # 1 fell of the sofa hurting the bridge of their nose. Report was reported within the required 24 hours. The purpose of the inspection was to obtain additional information and documentation regarding the incident reported to the Department.



LPA conducted interviews with Licensee- who disclosed that she was sitting on the carpet playing with a child and her husband was sitting on the couch with two children. Child # 1 stood on the couch and as they were trying to sit back down they fell forward, hitting the bridge of their nose. Area was cleaned and pressure was applied. Licensee, called parents who then took child to the doctor where they received stiches. Per Licensee, child is still out due to planned vacation but will be returning to the facility.

LPA observed the area, the table where child hit has been removed from area.

At this time, the licensee is in compliance with California Code of Regulations Title 22. No deficiencies cited.



A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Licensee Ruichan Situ ----------------------- pg 1 of 1 ----------------------------
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Roxana Lopez
LICENSING EVALUATOR SIGNATURE: DATE: 07/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/02/2024
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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