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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376629120
Report Date: 08/31/2021
Date Signed: 08/31/2021 10:53:59 AM

Document Has Been Signed on 08/31/2021 10:53 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: DATE:
08/31/2021
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Emma Ah SIngTIME COMPLETED:
11:00 AM
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On 08/31/2021 at 10:00 a.m. an office meeting was conducted with applicant, Emma Ah Sing to review the pending Family Child Care Home application received on 05/04/2021. Present at the meeting were Licensing Program Managers (LPMs), Jason Garay and Tulam Vu and Licensing Program Analyst (LPA), Martha Malane. During this meeting, Health and Safety Code1596.78(a) & California Code of Regulations 102417(a) were reviewed to ensure a thorough understanding.

· Health and Safety Code1596.78(a) “Family Day Care Home" means a home that regularly provides care, protection, and supervision for 14 or fewer children, in the provider’s own home, for periods of less than 24 hours per day, while the parents or guardians are away, and is either a large family day care home or a small family day care home.

· CCR 102417(a) Operation of a Family Child Care Home: The licensee shall be present in the home and shall ensure that children in care are supervised at all times.

Discussed with applicant regarding residency requirements and applicant stated she will be the primary caregiver to children in care. Applicant was informed that failure to comply with licensing laws and regulations will result in administrative action against the license.

Applicant stated she understood and will comply with all regulations and laws governing Family Child Care Home. A small Family Child Care Home license is granted effective today, 08/31/2021.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Martha Malane
LICENSING EVALUATOR SIGNATURE: DATE: 08/31/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/31/2021
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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