<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376627323
Report Date: 08/29/2023
Date Signed: 08/29/2023 05:10:12 PM

Document Has Been Signed on 08/29/2023 05:10 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: 9CENSUS: 9DATE:
08/29/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
04:01 PM
MET WITH:Haiqin Chen and Zhijin WangTIME COMPLETED:
05:15 PM
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 08/29/2023, Licensing Program Analyst (LPA) Selina Siao conducted an unannounced case management inspection. Upon arrival LPA met with licensee Haiqin Chen who was at the facility supervising 9 day care children including 4 infants during nap time. Co-Licensee Mr. Zhijin Wang arrived to the facility at 3:16pm and helper Jia Ying arrived at the facility at 3:28pm. Facility is found to be out of ratio during today's inspection.

See LIC809D for type A citation issue.




LPA Selina Siao informed licensee Zhijin Wang that this report dated 08/29/2023 document one (out of ratio) Type A citation which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care.

Also, LPA Selina Siao informed the licensee to provide a copy of this licensing report dated 08/29/2023 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Selina Siao
LICENSING EVALUATOR SIGNATURE: DATE: 08/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/29/2023
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 2
Document Has Been Signed on 08/29/2023 05:10 PM - It Cannot Be Edited


Created By: Selina Siao On 08/29/2023 at 04:40 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: WANG, ZHIJIN & CHEN, HAIQIN FAMILY CHILD CARE
FACILITY NUMBER: 376627323

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/29/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/30/2023
Section Cited
CCR
102416.5(e)

1
2
3
4
5
6
7
Staffing Ratio and Capacity
If no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home as specified in subsections (b) and (c).
1
2
3
4
5
6
7
Co-licensee Zhijin Wang was provided with the capacity chart and was informed that the facility must have a helper at all times if operating in a large capacity. A written plan of correction shall be submitted to LPA by later than 08/30/2023.
8
9
10
11
12
13
14
This requirement is not met as licensee Haiqin Chen was alone supervising 9 children including 4 infants during nap time without a helper. This poses an immediate health and safety risk to children in care.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
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:Tashima Daniel
LICENSING EVALUATOR NAME:Selina Siao
LICENSING EVALUATOR SIGNATURE:
DATE: 08/29/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/29/2023


LIC809 (FAS) - (06/04)
Page: 2 of 2