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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376629120
Report Date: 08/11/2021
Date Signed: 08/11/2021 09:53:57 AM

Document Has Been Signed on 08/11/2021 09:53 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:AH SING, EMMA FAMILY CHILD CAREFACILITY NUMBER:
376629120
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
08/11/2021
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:37 AM
MET WITH:Emma Ah SingTIME COMPLETED:
10:00 AM
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On 8/11/2021 at 9:30am, Licensing Program Analyst (LPA), Martha Malane conducted an unannounced second pre-licensing inspection. Upon arrival, LPA met with applicant, Emma Ah Sing and homeowner, Theodore Shank and disclosed the purpose of today's second pre-licensing inspection and was granted entrance to the home and proceeded on a tour.

The purpose of today’s second pre-licensing inspection is to verify the dining room fireplace and backyard air conditioner unit are inaccessible to children. LPA observed the dining room fireplace to have a secure screen, making the fireplace inaccessible at this time. LPA observed the back-yard air conditioner unit to have fence surrounding the unit making the unit inaccessible to children at this time. Applicant will utilize the backyard for outdoor activities.

An exit interview was conducted with applicant and homeowner. The LIC809 report was provided. After an office meeting with applicant, Emma Ah Sing and a final file review, a small family childcare license may be issued.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Martha Malane
LICENSING EVALUATOR SIGNATURE: DATE: 08/11/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/11/2021
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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