376101333-6-19-2023-51-CC-ASUD-CSXMDV-20230619093147

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376101333
Report Date: 06/19/2023
Date Signed: 06/19/2023 09:31:57 AM

Document Has Been Signed on 06/19/2023 09:31 AM - 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, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME:	LIU, SIQI FAMILY CHILD CARE		FACILITY NUMBER:	376101333
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 3	DATE:	06/19/2023
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	08:15 AM
MET WITH:	Siqi Liu		TIME COMPLETED:	09:40 AM

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 6/19/23 at 8:15 am LPA Annette Sutherland conducted an unannounced case management site visit for a capacity increase. This visit is to verify that the licensee remains in substantial compliance with the health & safety standards as required by regulations governing family childcare homes. LPA met with licensee Siqi Liu , also present during inspection was Licensee’s husband, Yuxiang Liu. Licensee has all appropriate forms posted. LPA confirmed with licensee that all adults residing/working in the home have criminal record/TB clearances. Applicant has obtained landlord consent to care for 14 children. The home appears to be large enough to comfortably accommodate 14 children. Fire clearance was received on 5/23/23. First Aid and CPR certifications expire on 10/2023. Children’s records were reviewed and found to be in order. Licensee has practiced fire/emergency drills (last drill conducted on 4/10/23) with day-care children according to regulations. The 2 story home ,5 bedroom, 3 bathroom was toured, the following areas are used for daycare: living room, dining room, downstairs bathroom, downstairs bedroom and backyard. Off limit areas include: entire upstairs, laundry room, kitchen, familyroom and garage. Off limit areas have been made inaccessible with the use of safety gates and/or doorknob covers. There is an operational smoke alarm, carbon monoxide detector and fire extinguisher maintained in the home. There are adequate age appropriate toys, books, games, napping mats, and hygienic diaper changing equipment. There are no firearms present on the premises as stated by licensee. Furthermore, there are no bodies of water. The outdoor play area is a fully fenced backyard, which is free of hazards and has sufficient toys. Per licensee, operating hours are from 7:30- 5:30 PM; 5 days a week.

SUPERVISOR'S NAME: Monica Cuddy	TELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Annette Sutherland	TELEPHONE: (619) 629-8751
LICENSING EVALUATOR SIGNATURE:	DATE: 06/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2023

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: LIU, SIQI FAMILY CHILD CARE	FACILITY NUMBER: 376101333
	VISIT DATE: 06/19/2023

NARRATIVE

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LPA reviewed the following: required departmental documents, regulation highlights, community resources, capacity limitations, supervision, clearances, emergency drills, heat related illness, child passenger law, unusual incidents, mandated reporting, Assembly Bill 633, SIDS, Safe sleep regulations, Shaken Baby Syndrome, and Megan's law. Applicant is reminded that corporal punishment, smoking, walkers, exersaucers, jumpers and bouncy seats shall never be permitted during day-care operation. Any equipment used should only be used according to the manufacturer recommendations.

For licensing regulations/updates/forms, go to web page http://www.ccld.ca.gov

Incidental Medical services (IMS) policy was discussed. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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: http://www.ada.gov/childqanda.htm.

No deficiencies are cited. No corrections are needed; a license for 14 children will be issued effective today.

The licensee was provided a copy of their appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights. LPA provided notice of site visit and observed it being posted at the facility.

SUPERVISOR'S NAME: Monica Cuddy	TELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Annette Sutherland	TELEPHONE: (619) 629-8751
LICENSING EVALUATOR SIGNATURE:	DATE: 06/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2023

LIC809 (FAS) - (06/04)

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