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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376627323
Report Date: 10/27/2023
Date Signed: 10/27/2023 12:56:40 PM

Document Has Been Signed on 10/27/2023 12:56 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
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:WANG, ZHIJIN & CHEN, HAIQIN FAMILY CHILD CAREFACILITY NUMBER:
376627323
ADMINISTRATOR:ZHIJIN W. & HAIQIN C.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 630-8898
CITY:SAN DIEGOSTATE: CAZIP CODE:
92127
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 10DATE:
10/27/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
12:10 PM
MET WITH:Haiqin Chen and Zhijin WangTIME COMPLETED:
12:20 PM
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On 10/27/2023 at 12:10pm, Licensing Program Analyst (LPA) Selina Siao conducted an unannounced plan of correction inspection to ensure that the facility is operating within compliance. Upon arrival, there were 10 children including 3 infants supervised by helpers Ying Jia and Min Zhang at the fenced backyard play area. Licensee Haiqin Chen was in the kitchen finishing cooking. Facility is within appropriate staffing ratio during today's inspection and all staff members have the required background clearances and are associated to the facility.

During the inspection co-licensee Zhijin Wang arrived at the facility with their school age son.


Notice of site visit was provided and it shall be posted for 30 days.


This report was translated in Chinese Mandarin by co-licensee Zhijin Wang.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Selina Siao
LICENSING EVALUATOR SIGNATURE: DATE: 10/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/27/2023
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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