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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198006190
Report Date: 04/21/2025
Date Signed: 04/21/2025 10:05:44 AM

Document Has Been Signed on 04/21/2025 10:05 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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:WU FAMILY CHILD CAREFACILITY NUMBER:
198006190
ADMINISTRATOR/
DIRECTOR:		WU,YAN YUNFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 272-3129
CITY:SAN GABRIELSTATE: CAZIP CODE:
91776
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
04/21/2025
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:30 AM
MET WITH:Yan Yun WuTIME VISIT/
INSPECTION COMPLETED:
10:15 AM
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On 04/21/2025, at 08:30 am, Licensing Program Analyst (LPA) Shushanik Safaryan and Licensing staff Youle Qi conducted case management visit per licensee request to change license status from inactive to active. Licensee primary language is Cantonese and licensing staff Youle Qi helped LPA with the translation. Upon arrival , Licensing staff, met with Yan Yun Wu, licensee who guided licensing staff on tour. During the visit Licensee`s husband was present too. There were no children present during the visit .During this inspection individuals who reside in the home were discussed and notes on Confidential Name List (LIC811) and attached to this report. Per applicant operation hours will be Monday to Friday , 8:00 a.m. to 6:00 p.m. Applicant states she will care for children 0-13 years old.

During this visit, all areas identified that are accessible for children to use were inspected for the safety, comfort, and cleanliness.
This is a two-story home which consists of 5 bedrooms, 5 bathrooms, living room , den area , laundry area, kitchen, attached garage, front yard and back yard fenced.
Areas available for the children as follow living room , den area, bathroom in the hallway on the first floor and part of the back yard .
Areas off limit for children and parents include: Entire second floor, bedroom on the first level, laundry area, kitchen , front yard and part of the back yard.

At 9:20 pm , Licensing staff , toured the home starting from the entry way. LPA observed child safety gate in the front separating living area from the entrance where stairs to the second floor observed. Per licensee children come enter to the living room and gate is always closed and children don’t have access to the second floor. Page 1 of 3
NAME OF LICENSING PROGRAM MANAGER: Brandi VanOosten
NAME OF LICENSING PROGRAM ANALYST: Shushanik Safaryan
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/21/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: WU FAMILY CHILD CARE
FACILITY NUMBER: 198006190
VISIT DATE: 04/21/2025
NARRATIVE
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 Next LPA observed child safety gate from both side of the kitchen , making kitchen inaccessible to the children. LPA toured living room and den area used by children . In the living room LPA observed couch , dining table, . In the den area LPA observed play pin and cots for napping, children’s toys. Next LPA toured the bathroom available for the children and did not observe any hazards. LPA observed hair supplies stored high inaccessible to the children. From the living room , children have access to the backyard which observed fenced. LPA observed part of the yard fenced where AC unit located and door to the garage. In the backyard LPA observed grass area and concrete area. During the visit, LPA observed off limit areas locked to prevent children access.

LPA observed the required 2A 10BC fire extinguisher indicates fully charged in the kitchen with the service date 02/02/2024. Smoke and carbon monoxide detectors observed in the hallway of the first level. There is telephone service via a cellphone that stays at the facility during operation hours.

Detergents, cleaning compounds, and medications were observed to be inaccessible to children. Per Licensee, there are no poisons in the home. LPA advised that any poisons should be locked under key or combination lock. Licensee states that there are no firearms or weapons stored in the home.

Per licensee, she will provide food for children in care. Licensee was advised that if food is brought from the children’s homes, all containers must be labeled with child’s name and properly stored or refrigerated.

At 9:30 am Licensee records were reviewed. 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 01/2026.

Per licensee, there are 2 small dogs in the house that stay in the garage. Licensee stated no weapons, firearms or bodies of water in the premises.

Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.
LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs, and/or any other item that fall into these categories are not permitted in a family childcare facility.
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NAME OF LICENSING PROGRAM MANAGER: Brandi VanOosten
NAME OF LICENSING PROGRAM ANALYST: Shushanik Safaryan
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/21/2025
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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: WU FAMILY CHILD CARE
FACILITY NUMBER: 198006190
VISIT DATE: 04/21/2025
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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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: https://www.ada.gov/resources/child-care-centers/.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.
LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

LPA advised the licensee how to access forms, regulations and quarterly updates on the Child Care Licensing website at www.ccld.ca.gov.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

Following was discussed with the licensee during the visit :

- Applicant will service Fire Extinguisher and email proof to LPA.

-Applicant will make sure all adults living in the facility will obtain fingerprint clearance.

Exit interview conducted and report was reviewed with the licensee Yan Yun Wu on 04/21/2025.

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NAME OF LICENSING PROGRAM MANAGER: Brandi VanOosten
NAME OF LICENSING PROGRAM ANALYST: Shushanik Safaryan
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/21/2025
LIC809 (FAS) - (06/04)
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