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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376626922
Report Date: 06/15/2023
Date Signed: 06/15/2023 04:42:51 PM

Document Has Been Signed on 06/15/2023 04:42 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:WANG, DAVID & SALLEW, YEZINA FAMILY CHILD CAREFACILITY NUMBER:
376626922
ADMINISTRATOR:DAVID WANG & YEZINA SALLEWFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(858) 228-7076
CITY:SAN DIEGOSTATE: CAZIP CODE:
92117
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: DATE:
06/15/2023
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
04:00 PM
MET WITH:David Wang and Yezina SallewTIME COMPLETED:
04:40 PM
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On 6/15/23 at 4:00 PM Licensing Program Manager (LPM), Renesha Askew, and Licensing Program Analyst (LPA), Adrian Mangina conducted a virtual office meeting with Licensees, David Wang and Yezina Sallew, via video conferencing (MS Teams). The purpose of this meeting is to discuss CCL expectations, Licensees' recent citation history, and provide an amended report for complaint #51-CC-20230228145733.

On 2/28/23 Licensees received a complaint, involving an allegation of inadequate supervision resulting in an inappropriate interaction between children in care. Although that allegation was found to be Unsubstantiated, Licensees were cited for a number of Type A and Type B violations at their most recent annual inspection on 2/8/23 and at case management inspections on 3/8/23 and 4/17/23.

Between 2/8/23 – 4/17/23 the facility received 2 Type A citations under sections 102425(h) for allowing a child to remain in an unbuckled car seat for 90 minutes after drop-off, 102416.5(b)(2) for being out of ratio with 1 staff caring for 4 infants and 2 toddlers. As well as 13 type B citations for having hazardous items accessible, not conducting disaster drills since licensure, not having a children’s roster, not having safe sleep plans for multiple infants in care, expired CPR/First Aid cards, not having children’s files, not having a current mandated reporter training certificate, and for using unpermitted equipment (bouncer). Licensees have received $1500 in failure to correct civil penalties. All deficiencies have been cleared as of 4/172023.

The following Regulations were reviewed and a copy of each listed were provided to Facility Representatives electronically: Section 102416 Personnel Requirements, Section 102416.1 Personnel Records, Section 102417 Operation of a Family Child Care Home, Section 102416.5 Staffing Ratio and Capacity, Section 102421 Child’s Records, Section 102423 Personal Rights, and Section 102425 Infant Safe Sleep. Prohibited Items capacity and ratios handouts provided.

continued on LIC809 page 2
SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Adrian L Mangina
LICENSING EVALUATOR SIGNATURE: DATE: 05/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/30/2023
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: WANG, DAVID & SALLEW, YEZINA FAMILY CHILD CARE
FACILITY NUMBER: 376626922
VISIT DATE: 06/15/2023
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LIC809 page 2

Licensees were also provided with Provider Information Notice (PIN) 21-01-CCLD regarding Guardian and Summer 2023 Quarterly update. LPA Provided Safe Sleep website: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep. Licensees were advised to regularly visit the Community Care Licensing WEB SITE: www.ccld.ca.gov for quarterly updates and regulation. Licensees stated they are signed up to receive the PIN's. During meeting licensee was provided the Duty Line: 619-767-2248.

Licensee was also provided with the CDSS Child Care Licensing (CCL) Family Child Care Providers Resource link with instructional videos: https://ccld.childcarevideos.org/family-child-care-providers/. It is recommended for Licensees to review the videos including, but not limited to: Supervising Children in Family Care, Record Keeping in a Family Child Care, Home Many Children Can Attend a Family Child Care, and Inaccessibility Requirements in a Family Child Care, Children’s Personal Rights in Child Care, Disaster Planning and Fire Safety, and What is a Civil Penalty.

Technical Service Program (TSP) referral was offered and accepted. TSP brochure provided. For questions related to TSP, email: Childcaretechnicalsupport@dss.ca.gov.

Licensees state they understand that they need to abide by Health and Safety Code and Title 22 Regulations in the operation of their Family Child Care Home.

A copy of this report, amended 5/15/2023 complaint report, appeal rights, and above stated documents were emailed to the Licensees at the conclusion of this meeting. The Licensee will confirm receipt of this report via e-mail and the reply of confirmation will serve as the signature acknowledging these rights.
SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Adrian L Mangina
LICENSING EVALUATOR SIGNATURE:

DATE: 06/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2023
LIC809 (FAS) - (06/04)
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