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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198017218
Report Date: 05/27/2021
Date Signed: 05/27/2021 10:10:13 AM

Document Has Been Signed on 05/27/2021 10:10 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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:GUAN FAMILY CHILD CAREFACILITY NUMBER:
198017218
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
05/27/2021
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Xiao Guan - LicenseeTIME COMPLETED:
10:20 AM
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Licensing Program Analyst (LPA) Nolan Tcheng conducted an in person Case Management-Licensee Initiated inspection. Upon arrival at 8:30am, LPA was let into residence by licensee Xiao Guan to whom the purpose of the inspection was announced. This inspection is being conducted for a requested capacity increase and to remove licensee from inactive status which expired 04/01/2021. Licensee remodeled home and inspection is to help match facility sketch received on 05/07/2021. The facility is requesting to increase from a small family child care with a capacity of 8, to a large family child care with a capacity of 14. Present during the inspection was licensee’s neighbor Lillian Cheng for the purpose of interpreting as the licensee’s primary language is Mandarin.

Licensee’s hours are currently Monday-Friday 8:30am-6:30am. Census: There were 0 children present during the time of inspection. LPA verified all persons who live in residence. Names provided on attached LIC811. This is a two-story home which consists of 4 bedrooms, 4 bathrooms, kitchen, living room, front yard and backyard (fenced), and garage. The children use the bathroom in the front of the house attached to the living room. Per licensee, areas off limits to children and parents include: the entire upstairs, downstairs bedroom, kitchen, staircase, and garage. The licensee provides food for children in care.

Licensee states that she currently has one assistant. All individuals present in the home have obtained a criminal record clearance or exemption prior to working, residing or volunteering. The licensee states that there are no poisons in the home and understands that storage areas for poisons must be locked with a key or combination lock. Per licensee, there are no weapons, firearms or bodies of water on the premises.


PHYSICAL PLANT
At 8:35am, LPA was lead on a tour of the facility by the licensee. The front part of the house where the tour began is the living room. The living room is the only child care area in the house with its own attached bathroom. Detergents, cleaning compounds, medications, and other items which could pose a danger are inaccessible to children with a child lock.
REPORT CONTINUES PAGE 1 of 3
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Nolan Tcheng
LICENSING EVALUATOR SIGNATURE: DATE: 05/27/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/27/2021
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 3
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: GUAN FAMILY CHILD CARE
FACILITY NUMBER: 198017218
VISIT DATE: 05/27/2021
NARRATIVE
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At 8:37am, Smoke and carbon monoxide detectors are located in the living room/child care area and were tested and are operable. The walkway to the rest of the house is made inaccessible with a child gate placed at the entrance of the living room. LPA reminded licensee that child gate should stay there at all times during operation hours. Licensee states she will make sure the child gate will remain at entrance of living room during operation hours. Applicants Initials: ___________. At 8:40am, the tour continued to the kitchen which is off limits to children. Due to licensee being inactive since 12/2019 and brand new remodeling of the residence, LPA toured all parts of the new facility sketch during this inspection. LPA observed the fire extinguisher underneath the kitchen sink at 8:42am with a receipt of purchase on 04/14/2021. Licensee led the LPA upstairs, which is all off limits to children. Where children are less than five years old are in care, stairs are fenced or barricaded. There is a child safety gate which keeps stairs inaccessible to children who will remain in the living room. At 8:45am, tour continued to the back yard which has a driveway that connects the front of the house. There is a gate available to close in front. The back yard will be used if given permission from the enrolled children's parents. At 8:50am Licensee showed LPA there are first aid supplies available and Emergency Disaster Plan, Parent’s Rights Poster and the Facility License are observed to be posted at front door in living room. Per licensee, there is no fireplace on the property and the licensee states that a cell phone is used and stays at the facility during operating hours. There are no pets on the premises. The licensee is observed to be operating within the license capacity limitations.

FACILITY RECORDS:
The licensee and other personnel have completed training on preventive health practices including Pediatric First Aid and CPR. The licensee's Pediatric First Aid and CPR expires on 04/2023. Licensee and other personnel have not completed Mandated Reporter as Mandarin is their primary language. The licensee doeshave proof of immunization against influenza, tuberculosis, pertussis, and measles. Children’s records were not reviewed as the facility does not have any enrolled children at this time. Licensee has an approved fire inspection dated 05/18/2021.

PROHIBITED: Infant Walkers, Johnny Jumpers, Saucer Chairs, Trampolines and/or any other item that falls into these categories are not permitted in a family child care facility. Smoking is prohibited in a license family child care home.

REPORT CONTINUES PAGE 2 of 3
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Nolan Tcheng
LICENSING EVALUATOR SIGNATURE:

DATE: 05/27/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/27/2021
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: GUAN FAMILY CHILD CARE
FACILITY NUMBER: 198017218
VISIT DATE: 05/27/2021
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Infant Care: Licensee states that she will care for infants. LPA advised the licensee to sleep infants where they can be directly supervised at all times and advised the licensee against sleeping infants in a separate room. Licensee states that infants sleep in the living room. LPA provided the licensee with a copy of the Child Care Provider’s Guide to Safe Sleep, by American Academy of Pediatrics and Helping you to reduce the risk of SIDS. LPA consulted and explained Child Abuse Reporting, Updated Patent’s Rights Poster with Complaint Hotline information, Never Shake a Baby, Sudden Infant Death Syndrome (SIDS), and Safe Sleeping practices.

Incidental Medical Services (IMS):
The licensee states that she will provide IMS. Per licensee, 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.

During this inspection LPA discussed PIN 20-06 CCP, Social And Physical Distancing Guidance And Healthy Practices For Child Care Facilities In Response To The Global Coronavirus (COVID-19) Pandemic Written In Collaboration With The California Department Of Education and reviewed Child Care Covid-19 Self Assessment.
LPA advised the licensee how to access forms, regulations and quarterly updates on line at: www.ccld.ca.gov. AB1207 Mandated Child Abuse Reporting – Implementation was discussed with Licensee. Website provided: http://mandatedreporterca.com/

At this time, the licensee is in compliance with California Code of Regulations Title 22. No deficiencies cited. The capacity increase to a large family child care home will be granted, pending final file review.



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 Xiao Guan, Licensee, including, but not limited to Provider Rights, Appeal Procedures, and the Agencies Consultative Role. END OF REPORT PAGE 3 of 3
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Nolan Tcheng
LICENSING EVALUATOR SIGNATURE:

DATE: 05/27/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/27/2021
LIC809 (FAS) - (06/04)
Page: 3 of 3