Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191596512
Report Date: 10/19/2017
Date Signed: 10/19/2017 01:11:02 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:TSENG FAMILY CHILD CAREFACILITY NUMBER:
191596512
ADMINISTRATOR:TSENG, WENDYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 458-8628
CITY:ALHAMBRASTATE: CAZIP CODE:
91801
CAPACITY:14CENSUS: 8DATE:
10/19/2017
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Wendy Tseng, LicenseeTIME COMPLETED:
01:15 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
Licensing Program Analysts (LPAs) Carlos Gonzalez and Ana Chico, conducted a Required - 3 year inspection to the above facility. LPAs met with Wendy Tseng, Licensee, who guided analysts on a tour of the facility. The licensee states that she currently has 8 children enrolled. A children’s roster was available and is current.

This is a single story home which consists of an office, 1 bedroom, 2 bathrooms, living room, dining room, den, kitchen, and laundry room, front and back yards. The home was inspected for safety, comfort, cleanliness, ventilation, and telephone service (land line). The children use the office, living room, dining room, middle bathroom, den and the back yard. Per licensee, areas off limits to children are both bedrooms, master bathroom, kitchen, and laundry room.

The licensee states that she is lives alone and is the only occupant of her facility (home). All individuals have obtained a criminal record clearance or exemption prior to working, residing or volunteering in a licensed home. Detergents, cleaning compounds, medications, and other items which could pose a danger, were inaccessible to children during this inspection.

The valve on the required 2A 10BC fire extinguisher indicates that it was last serviced in December of 2016. Per State Fire Marshall standards, fire extinguishers shall be serviced annually. Smoke detectors were tested and are working properly. There was no carbon monoxide detector present. There are age appropriate toys available for children. Per licensee, there are no weapons, firearms or bodies of water on the premises.

REPORT CONTINUES ON THE NEXT PAGE - 1 OF 3
SUPERVISOR'S NAME: Cassandra CooperTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Carlos GonzalezTELEPHONE: (323) 981-3376
LICENSING EVALUATOR SIGNATURE:

DATE: 10/19/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2017
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 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: TSENG FAMILY CHILD CARE
FACILITY NUMBER: 191596512
VISIT DATE: 10/19/2017
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
26
27
28
29
30
31
32
Infant Care: Licensee states that she does not care for infants at this time.

Incidental Medical Services (IMS): The licensee states that there are no children enrolled that require IMS at this time. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

LPA advised the licensee how to access forms, regulations and quarterly updates on line at: www.ccld.ca.gov.

Based on the LPA’s observations and records review, the following deficiencies listed on the attached LIC 809 (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.



The Notice of Site Visit (LIC 9213)must remain posted for 30 days during the hours of operation after each site visit made by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

Exit interview was conducted with Wendy Tseng, Licensee, including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role.

REPORT END - 3 OF 3
SUPERVISOR'S NAME: Cassandra CooperTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Carlos GonzalezTELEPHONE: (323) 981-3376
LICENSING EVALUATOR SIGNATURE:

DATE: 10/19/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2017
LIC809 (FAS) - (06/04)
Page: 2 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: TSENG FAMILY CHILD CARE
FACILITY NUMBER: 191596512
VISIT DATE: 10/19/2017
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
26
27
28
29
30
31
32
The licensee was observed to be operating within the licensed capacity limitations during this inspection. The licensee has completed training on preventive health practices including Pediatric First Aid and CPR. The licensee's Pediatric First Aid and CPR expires on 5/2019. There are first aid supplies available.

UPDATE: H&S 1597.622: Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.
Children’s records were reviewed, including but not limited to, a copy of the emergency information card that contains all of the information required by regulation. LPA issued a Confidential Names List (LIC 811) to the licensee which documents the staff and/or children’s files that were reviewed during this inspection.

The following items were also discussed with licensee during this inspection.


· All homes shall conduct fire and disaster drills at least once every six months, and document the date and time of each drill. Last drill documented was conducted on 09/2017.
· POSTING REQUIREMENTS: Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted.
· Infant Walkers, Johnny Jumpers, Saucer Chairs, Trampolines or any other item that falls into these categories are not permitted in a family child care facility. SMOKING IS PROHIBITED IN A LICENSED FAMILY CHILD CARE HOME.

There were NO ZERO TOLERANCE deficiencies cited during this visit. Zero Tolerance include: Absence of Supervision, the licensee understands that arrangements must be made for a substitute adult to care and supervise children when they are absent from the home; Accessible Bodies of Water; No bodies of water on the premises; Accessible Firearms, Ammunition or Both; No firearms or weapons in the home; Refused Entry to a Facility or Any Part of a Facility in Violation of Section 1596.852, 1596.853 or 1597.09. Regulations 101238 (g)(2); The Presence of an Excluded Individual. No excluded individuals; Children are not left in parked vehicles.

REPORT CONTINUES ON THE NEXT PAGE - 2 OF 3
SUPERVISOR'S NAME: Cassandra CooperTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Carlos GonzalezTELEPHONE: (323) 981-3376
LICENSING EVALUATOR SIGNATURE:

DATE: 10/19/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2017
LIC809 (FAS) - (06/04)
Page: 3 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: TSENG FAMILY CHILD CARE
FACILITY NUMBER: 191596512
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/19/2017
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/27/2017
Section Cited
HSC
1597.543
1
2
3
4
5
6
7
Every family day care home for children shall have one or more carbon monoxide detectors in the facility that meet the standards established in Chapter 8 (commencing with Section 13260) of Part 2 of Division 12. The department shall account for the presence of these detectors during inspections.
1
2
3
4
5
6
7
Licensee stated that she will have an operable carbon monoxide detector by POC date.
8
9
10
11
12
13
14
Licensee did not have an operable carbon monoxide detector.
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: Cassandra CooperTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Carlos GonzalezTELEPHONE: (323) 981-3376
LICENSING EVALUATOR SIGNATURE:

DATE: 10/19/2017
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2017
LIC809 (FAS) - (06/04)
Page: 4 of 4