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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 344500802
Report Date: 01/19/2024
Date Signed: 01/19/2024 03:48:07 PM

Document Has Been Signed on 01/19/2024 03:48 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
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:XIONG, DANFACILITY NUMBER:
344500802
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
01/19/2024
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Dan XiongTIME COMPLETED:
04:00 PM
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Licensing Program Manager (LPM) Bettina Engelman and Licensing Program Analyst (LPA) Corina Beckby met with Licensee, Dan (Nicole) Xiong and Licensee’s friend/interpreter Ying Chan for the purpose of an Informal Office Meeting. LPM Engelman defined the difference between a Non-Compliance and an Informal Meeting. LPM advised Ms. Xiong the purpose of today’s meeting is to help provider gain compliance.

Today's informal meeting was to discuss the Type A citation issued on 06/16/23 for over capacity when Licensee was caring for 8 children (including 2 infants) and no school age children. At this time, a Type B citation was also issued for not maintaining children’s files/records.

The facility was also cited a Type B citation on 11/29/23 for not reporting 2 Unusual Incident/Injury Reports.

The Licensee stated that they have taken the following steps to maintain compliance. Licensee understands reporting requirements. Licensee is aware of reporting requirements and will contact LPA if she has any questions. Licensee has changed family schedules to maintain capacity limits. Licensee has maintained all required forms for children enrolled as documented during last inspection.

LPA and LPM reminded Licensee of her responsibility for providing supervision and maintaining communication with families and department/LPA. LPM and LPA provided information regarding training videos on Supervision and the Technical Support Program (TSP), which is a non-enforcement arm of the Community Care Licensing Division offering on site support to licensees and providers. LPA will follow-up with Licensee Dan Xiong for TSP services. LPA discussed using the Department website (ccld.ca.gov) for child care updates, legislation, forms and regulation information. LPM suggested viewing information videos at www.ccld.childcarevideos.org.
This report was reviewed by Licensee Dan Xiong.
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Corina Beckby
LICENSING EVALUATOR SIGNATURE: DATE: 01/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/19/2024
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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