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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364846281
Report Date: 12/22/2023
Date Signed: 12/22/2023 04:48:22 PM

Document Has Been Signed on 12/22/2023 04:48 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
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:YANG FAMILY CHILD CAREFACILITY NUMBER:
364846281
ADMINISTRATOR:YANG, YITINGFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 981-1612
CITY:ONTARIOSTATE: CAZIP CODE:
91762
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 6DATE:
12/22/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:50 PM
MET WITH:Yiting YangTIME COMPLETED:
05:00 PM
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On 12/22/23 a case management inspection is being conducted in response to the receipt of an Unusual Incident Report (UIR) from the facility. Licensing Program Analyst (LPA) Blanca Ruiz met with licensee, Yiting Yang and licensee’s assistant Samantha Gonzales to follow-up on the UIR submitted to the department. Facility was toured and census was taken. Interviews were conducted and records were reviewed. Further information will be needed. Upon completion of the review, the outcome and/or recommendations will be provided to the licensee.

An exit interview conducted, and report was reviewed with licensee, Yiting Yang. Appeal rights were discussed, and 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.


THIS REPORT MUST BE AVAILABLE TO THE PUBLIC, UPON THEIR REQUEST, FOR THREE YEARS.
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Blanca Ruiz-Silva
LICENSING EVALUATOR SIGNATURE: DATE: 12/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/22/2023
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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