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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191595964
Report Date: 12/20/2024
Date Signed: 12/20/2024 11:49:36 AM

Document Has Been Signed on 12/20/2024 11:49 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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:PHORNSUTIPHAIJIT FAMILY DAY CAREFACILITY NUMBER:
191595964
ADMINISTRATOR/
DIRECTOR:		PHORNSUTIPHAIJIT, BLANCAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 806-3276
CITY:DOWNEYSTATE: CAZIP CODE:
90241
CAPACITY: 12TOTAL ENROLLED CHILDREN: 2CENSUS: 1DATE:
12/20/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Blanca PhornsutiphajitTIME VISIT/
INSPECTION COMPLETED:
12:00 PM
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12/20/24, at 10:00AM, Licensing Program Analyst (LPA) T. Tran arrived at the above licensed facility to conduct an annual inpsection. Upon arrival, LPA met with licensee, Blanca Phornsutiphajiand announced the purpose of today’s visit. About 10:20 AM, we toured the accessible areas of the home. All adults have fingerprinted cleared and associated to the licensed facility.
LPA observed all posting requirements for operation on the posting board LIC 203A-License, LIC-9213-Notice of site visit, LIC 610 A-Emergency Disaster Plan, LIC 9148-Earthquake Preparedness Check List, PUB 394-Notification of parent’s rights poster, and PUB 269- Child Car Seat Law.
This is a single dwelling home consisting of 3 bedrooms, 2 bathrooms, a living room/dining area, a kitchen, and an attached garage. Childcare is conducted in the living room. Children do not have access to the kitchen area. LPA observed the kitchen have a safety gate made the area inaccessible to children in care. Children do not have access to three bedrooms and the living room. The licensee acknowledged that children may never enter these off-limit areas. The enclosed backyard is observed to be clean with lots of learning materials available for children. The licensee is reminded that smoking is prohibited on the premises. LPA informed the effects of lead exposure for children between ages 1-6 years old are the most at risk for lead poisoning. A copy of lead exposure was provided.
LPA observed all posting requirements accessible to all parents. Licensee had current CPR/First Aid certificates (Exp. 4/2025), fire extinguisher, carbon monoxide and smoke detector meet regulations. Cleaning materials and medications are inaccessible, Licensee stated there are no firearms in the home. The home conducted emergency disaster drill on a monthly basis. Children’s record was reviewed and completed.
The licensee was informed of the responsibility to report suspected Child Abuse by calling the Child Abuse Hotline at 1-800-540-4000. Also call the Community Care Licensing office and follow up with a written Unusual Incident/Injury Report (LIC 624B).
LPA informed the Childcare Advocate Program (CCAP) to provide many other helpful resources to the licensees and the public. Visit www.cdss.ca.gov to receive important updates.
SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Tiffanie Tran
LICENSING EVALUATOR SIGNATURE: DATE: 12/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/20/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: PHORNSUTIPHAIJIT FAMILY DAY CARE
FACILITY NUMBER: 191595964
VISIT DATE: 12/20/2024
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Beginning January 1, 2018, Health and Safety Code 1596.8662 requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Volunteers are encouraged but not required to take the training. Existing licensees must meet requirements by March 30, 2018. New employees shall have 90 days from the date of employment to complete training as required. This training requirement may be met by using the Department’s Office of Child Abuse Prevention (OCAP) online training modules. Visit: https://mandatedreporterca.com
To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.
Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Childcare Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.
Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Childcare 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
Licensee was informed of the MYChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting the to child care providers and Resource and Referral Agencies (R&Rs) throughout California.
During the exit review, the licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.
No deficiency was cited during today’s visit. Notice of site visit was given and must remain posted for 30 days.
Exit interview conducted and report was reviewed with the licensee,Blanca Phornsutiphaji.
SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Tiffanie Tran
LICENSING EVALUATOR SIGNATURE:

DATE: 12/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2024
LIC809 (FAS) - (06/04)
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