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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376616318
Report Date: 12/16/2022
Date Signed: 12/16/2022 02:23:18 PM

Document Has Been Signed on 12/16/2022 02:23 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, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:NGUYEN, ASHLEY & BE FAMILY CHILD CAREFACILITY NUMBER:
376616318
ADMINISTRATOR:ASHLEY & BE NGUYENFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(858) 208-6488
CITY:SAN DIEGOSTATE: CAZIP CODE:
92131
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 7DATE:
12/16/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Ashley NguyenTIME COMPLETED:
02:45 PM
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On 12/16/2022 at 11:30AM, Licensing Program Analyst's (LPA) Samantha Clenista and Gerald Poindexter conducted an unannounced random inspection. Upon arrival, LPA's were greeted by Licensee's helper, Lisa Yentrang Le-Nguyen (aka Yen Le). Also present was another helper, Minhtam Tran, and 7 day care children. Co-Licensee, Ashley Nguyen arrived later on in the visit to conclude inspection. The home was toured and inspected to ensure an environment safe for the care and supervision of children. The children were observed playing inside the activity area, appropriately supervised.

Licensee has provided adequate space for the children to eat, sleep and play within the home. Areas Licensee stated she uses for child care include the following areas: family room, library/extra room, kitchen, dining room, living room and downstairs bathroom. The fireplace located in the family room has a glass door inaccessible to children. Off limit areas include the entire upstairs, laundry room and garage. Off limit areas have been made inaccessible with the use of safety gates and/or door knob covers. The facility has sufficient toys and equipment available. The home has a fenced backyard available for outdoor activities that Licensee stated she has not used in about a month due to construction and weather. LPA's observed some hazardous items in the backyard such as broken tiles, broken wood, broken glass, broken light stand, broken side fence. Licensee stated she will take walks with the children for outdoor play while she works on cleaning her backyard. Licensee stated she will provide LPA with pictures once backyard is cleaned and appropriately safe for children to play.

The home has a fully charged fire extinguisher, smoke and carbon monoxide detector that meet requirements and are operational. LPA's observed there to be an in-ground pool located in the backyard. Bodies of water was observed to be appropriately inaccessible via mesh fencing and self-latching gate. LPA's also observed an area in the front yard where water can accumulate, however Licensee stated that there is a drain to refrain from water accumulating if it rains. LPA's observed the drain and reminded Licensee to check this area sporadically to ensure that there is no water accumulating enough where a child can drown. Licensee stated her understanding.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Samantha Clenista
LICENSING EVALUATOR SIGNATURE: DATE: 12/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/16/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 5
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: NGUYEN, ASHLEY & BE FAMILY CHILD CARE
FACILITY NUMBER: 376616318
VISIT DATE: 12/16/2022
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A review of staff records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances. Licensee's EMSA approved First Aid and CPR certifications are valid through 07/02/24. All seven of the children (that were present) records were reviewed and observed in compliance. Facility has an updated roster and fire/disaster drill log available for review. Licensee's and helpers Mandated Reporter Training Certificate per AB1207 were expired on 01/03/2022. Licensee last conducted a drill was an fire drill on 10/03/2022. A copy of the facility roster was obtained during today’s inspection.

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

The following items were discussed with provider: Licensee was reminded that corporal punishment, smoking, exersaucers, bouncy seats, walkers, and jumpers are not allowed in day care. Effects of Lead Exposure and reporting responsibilities were discussed. The ABC’S of Safe Sleep: Sleep is Safest: Alone, on their Back in an empty Crib on a firm mattress.

Child Care Providers can now sign up for Quarterly Updates and PINS through the DSS website at https://cdss.ca.gov/inforesources/community-care-licensing/subscribe. LPA discussed California Megan's Law with provider and advised her to go on the website at www.meganslaw.ca.gov.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Samantha Clenista
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2022
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: NGUYEN, ASHLEY & BE FAMILY CHILD CARE
FACILITY NUMBER: 376616318
VISIT DATE: 12/16/2022
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Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

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-and-resources/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.

See LIC809D for cited deficiencies. Exit interview conducted and report was reviewed with the licensee at conclusion of visit. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Samantha Clenista
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2022
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 12/16/2022 02:23 PM - It Cannot Be Edited


Created By: Samantha Clenista On 12/16/2022 at 02:00 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
, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: NGUYEN, ASHLEY & BE FAMILY CHILD CARE
FACILITY NUMBER: 376616318

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/16/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(j)(1)

The provider shall physically check on the infant every 15 minutes and document it.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review and Licensee's own admission, the licensee did not comply with the section cited above by not maintaining a log of 15 minute checks documenting labored breathing, signs of distress, and position which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/06/2023
Plan of Correction
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LPA provided Licensee a copy of safe sleep log to start logging infant's under 2 years old sleeping their behavior every 15 minutes. Licensee stated she will implement this immediately and let her helpers know as well. LPA also provided Licensee various Safe Sleep resources via email. Licensee stated she will review all resources and provide LPA a statement stating she understands the regulations no later than POC due date.
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.
SUPERVISOR'S NAME:Monica Cuddy
LICENSING EVALUATOR NAME:Samantha Clenista
LICENSING EVALUATOR SIGNATURE:
DATE: 12/16/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/16/2022


LIC809 (FAS) - (06/04)
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