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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198017218
Report Date: 07/14/2022
Date Signed: 07/14/2022 04:28:01 PM

Document Has Been Signed on 07/14/2022 04:28 PM - 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:GUAN, XIAOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 757-1268
CITY:SAN GABRIELSTATE: CAZIP CODE:
91776
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 8DATE:
07/14/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Licensee, Xiao GuanTIME COMPLETED:
04:35 PM
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Licensing Program Analyst (LPA), Bardo Baluyot conducted an unannounced annual inspection. LPA met with Licensee, Xiao Guan, who guided analyst on a tour of the facility. LPA conducted a COVID risk self-assessment upon entry. Licensee's husband, Wei Liu, was also present and translated during the inspection as the Licensee’s primary language is Mandarin. There were eight day care children present at the time of the inspection. Four were observed to be infants and four children between the ages of 3-5 years of age. A current children’s roster was available and is current. The licensee is observed to be operating within the license capacity limitations.

Per Licensee, hours are currently Monday-Friday 8:30am-6:00pm. LPA verified all persons who live in residence. Per Licensee, her husband is her assistant in the day care and that (4) adults who have clearances on file live in the home and (1) minor child. The Licensee's son was not present but is over the age of 10. All individuals present in the home have obtained a criminal record clearance or exemption prior to working, residing or volunteering. 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.

All areas identified on the facility sketch that children use, were inspected for safety, comfort, cleanliness, telephone service, ventilation and heating (air conditioning). Detergents, cleaning compounds, medicines, sharp objects and hazardous items that can pose a danger to children are inaccessible in some areas in the home. 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 observed the fire extinguisher underneath the kitchen sink with a receipt of purchase on 06/19/2022. LPA toured the fenced backyard which has a driveway that connects the front of the house.

SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Bardo Baluyot
LICENSING EVALUATOR SIGNATURE: DATE: 07/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/14/2022
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: 07/14/2022
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Per Licensee, there is no fireplace on the property and that a cell phone is used and stays at the facility during operating hours. Per licensee, there are no pets, weapons, firearms or bodies of water on the premises. There were age appropriate toys observed for children. Posting requirements observed. Both the Licensee and Licensee's husband/assistant's Pediatric First Aid and CPR, expire on 4/3/2023.

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.

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

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 Child Care 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.


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. The licensee has a disaster drill available.
  • 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 and/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.

SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Bardo Baluyot
LICENSING EVALUATOR SIGNATURE:

DATE: 07/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2022
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: 07/14/2022
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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.


At this time, the Licensee is in compliance with California Code of Regulations Title 22. No deficiencies cited during today's inspection.

Exit interview conducted and report was reviewed with the licensee, Xiano Guan.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

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.

END OF REPORT

SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Bardo Baluyot
LICENSING EVALUATOR SIGNATURE:

DATE: 07/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2022
LIC809 (FAS) - (06/04)
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