198021437-3-27-2024-33-CC-NTCG-D3RP22-20240327105512

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198021437
Report Date: 03/27/2024
Date Signed: 03/27/2024 10:55:24 AM

Document Has Been Signed on 03/27/2024 10:55 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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	WANG FAMILY CHILD CARE		FACILITY NUMBER:	198021437
ADMINISTRATOR:	WANG, SHUNAN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(626) 272-6818
CITY:	ARCADIA	STATE: CA	ZIP CODE:	91006
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 2	DATE:	03/27/2024
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Shunan Joyce Wang - Applicant		TIME COMPLETED:	11:15 AM

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) Nolan Tcheng and Saul Valenzuela conducted a pre-licensing inspection today. Upon arrival at 8:30am, LPAs met with Shunan Wang, Applicant who guided analyst on a tour of the facility. Persons residing in the home are 2 adults and 2 minors. This is a change of location application. Applicant is previously licensed as #198020757. Per applicant operation hours will be Monday to Friday 6am-6pm. Applicant states she will care for children 0-12 years old. All areas identified on the facility sketch were inspected. This is a one story house. The home consists of 3 bedrooms, 2 restrooms, living room and kitchen. There is a fireplace in the living room which has been blocked off to prevent access to children. Areas that are accessible to children are as follows: Bathroom in the hallway, living room, bedrooms, backyard. Areas off limits based on facility sketch submitted to children and parents include: Master bedroom and bathroom #2, bedroom #3, kitchen, attached garage, side yards, and front yard. Rooms that are off-limits need to be made inaccessible during operating hours The backyard is adequately fenced and there are no swimming pools, spa or other bodies of water observed on the premises. Children will be always physically and visually supervised while in the backyard. LPAs observed there are age-appropriate toys and napping equipment. There is one small dog that stay in the off-limits area during operation hours. Applicant states that they will check the backyard for animal waste prior to allowing children in the area. Applicant's Initials ________________. The applicant does understand that licensing staff may have access to off-limit areas during inspection visit if necessary. Page 1 of 6

SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Nolan Tcheng
LICENSING EVALUATOR SIGNATURE:	DATE: 03/27/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2024

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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: WANG FAMILY CHILD CARE	FACILITY NUMBER: 198021437
	VISIT DATE: 03/27/2024

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At 8:50am, the applicant began touring with LPAs though the home starting with the entry way which led directly to the living room, The living room was inspected, and electrical outlets were observed to be covered. Next to the living room, the kitchen was inspected, and LPA observed a latch on the cabinet under the kitchen island which stores cleaning compounds. The medications and knives are stored in a cabinet under the kitchen island out of reach for children. The kitchen is made inaccessible to children by two safety gates on either side of the kitchen island. LPAs advised that should the applicant have older children in care that may reach the cabinet, that they be secured. The isolation room is in the bedroom located at the end of the hall to the left. The other two bedrooms and bathroom in the master bedroom is off limits to children. Hallway is inaccessible to children by a safety gate. No poisons are kept in the home.

Per applicant, there is a firearm on the premises. Storage of firearm was reviewed and is in compliance. At 9:15 am, applicant showed LPAs the fire extinguisher, which did not have proof of purchase or services date. LPAs observed Fire Extinguisher was anchored to the wall next to the front entrance door. Applicant also tested the carbon monoxide and smoke detector combination detector in the hallway. The detector sounded off the alarms and heard by LPAs to be functional. There are emergency supplies in the cabinet in the kitchen.

Applicant has proof of CPR and First Aid training as indicated on the certificate. The applicant does have proof of Health and Safety training completed via college courses, transcript is on file, Pediatric First Aid and CPR expires 3/2026. Mandated Reporter training was completed and expires:3/21/2025.

The following was discussed with the applicant:
-In the absence of the licensee a qualified adult must be present supervising the children; a qualified adult is an individual who has a valid and current adult/infant CPR & Pediatric First Aid certification and a valid criminal record clearance associated to the facility license.
-A current roster of children enrolled must be available and maintained for a period of three years, even after children no longer are attending the facility.
-Annual fees must be paid promptly and by the due date or a late fee shall be assessed and/or the License shall be terminated.
-The fire extinguisher type 2A-10BC must be serviced annually or as often as necessary and smoke and carbon monoxide detectors should check and batteries replaced as needed.

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SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Nolan Tcheng
LICENSING EVALUATOR SIGNATURE:	DATE: 03/27/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2024

LIC809 (FAS) - (06/04)

Page: 2 of 6

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: WANG FAMILY CHILD CARE	FACILITY NUMBER: 198021437
	VISIT DATE: 03/27/2024

NARRATIVE

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-Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your home.
-Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing. (use LIC624B for written report)
-Fire and safety drills must be performed every six months and documented for review by the Department.
-Smoking is prohibited in a family child care home.
-Children and Staff records must be maintained and updated as needed and must be available for review by the Department.
-Dog(s) and or pets are recommended to be isolated from children in care
- No smoking, No infant walkers, No Johnny jumpers, No saucer chairs, and any other item that falls into that category are not permitted in the facility. -All adults living and working in the home shall be made of aware of the Departments right to inspection authority, which includes but not limited to the right to enter the home when children are being cared for, interview children and adults and review documentation. - Applicant shall reveal each facility license number in all advertisements, publications or announcements with the intent to attract clients. - Emergency Disaster Plan, Parent’s Rights Poster and the Facility License are required to be posted.

Infant Care: Applicant states that she does care for infants. LPAs advised the applicant to sleep infants where the infant can be directly supervised and advised against sleeping infants in a separate room. The applicant states that she will not sleep infants in a separate room. LPAs reviewed SIDs, Never Shake A Baby, and safe sleeping practices. Infants should sleep mouth up, on their backs, free of clutter surrounding their sleeping space. Safe sleep concepts were provided.

Applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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.

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SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Nolan Tcheng
LICENSING EVALUATOR SIGNATURE:	DATE: 03/27/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2024

LIC809 (FAS) - (06/04)

Page: 3 of 6

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: WANG FAMILY CHILD CARE	FACILITY NUMBER: 198021437
	VISIT DATE: 03/27/2024

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Because the applicant rents/leases the home, proof of landlord notification is required. The LPAs observed the Property Owner/Landlord Notification form (LIC9151) that the applicant confirms was provided to the property owner/landlord. The applicant obtained a signed Property Owner/Landlord Consent form (LIC 9149).

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) or (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

LPAs reviewed with applicant the LIC 311D, Forms/Records to Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. Entrance Checklist was provided to the applicant.

Applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

LPAs discussed the safe sleep regulations with the applicant and discussed the Child Care Licensing Safe Sleep webpage at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed [applicant, licensee, or facility representative] 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.

On this date, 10/19/2023, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

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SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Nolan Tcheng
LICENSING EVALUATOR SIGNATURE:	DATE: 03/27/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2024

LIC809 (FAS) - (06/04)

Page: 4 of 6

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: WANG FAMILY CHILD CARE	FACILITY NUMBER: 198021437
	VISIT DATE: 03/27/2024

NARRATIVE

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Per applicant, she does not carry liability insurance or a bond in accordance with standard established by Family Child Care statue. Signed statements (LIC282) will be on children’s files. The law requires Family Child Care provider to carry liability insurance or bond in the amount of $300,000 annually or to maintain the signed statement in the facility file.

The applicant does have proof of immunization against influenza, pertussis, and measles.

Applicant completed required mandated reporter training on 03/21/2025. Mandated reporter training must be completed every 2 years. www.mandatedreporterca.com

LPAs consulted and explained Child Abuse Reporting, Effects of Lead Exposure Flyer, Updated Patent’s Rights Poster with Complaint Hotline information, Capacity Handout (Small & Large) was provided during this inspection.

Per applicant, there are no dual licenses at this address. Applicant’s email address was obtained during this inspection. The applicant was advised that email may be public information.

During this inspection LPAs 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 consulted and explained Child Abuse Reporting, Effects of Lead Exposure Flyer, Updated Patent’s Rights Poster with Complaint Hotline information, Capacity Handout (Small & Large) was provided during this inspection.

LPA advised the applicant how to access forms, regulations and quarterly updates, and Provider Information Notices (PIN) on the Child Care Licensing website at: www.ccld.ca.gov. LPA reviewed and issued the Forms/Records to Keep in Your Family Child Care Home (LIC 311D) and provided the following forms:

CHILDREN FORMS/RECORDS , FACILITY FORMS/RECORDS , INFORMATION TO BE POSTED IN YOUR FAMILY CHILD CARE HOME

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SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Nolan Tcheng
LICENSING EVALUATOR SIGNATURE:	DATE: 03/27/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2024

LIC809 (FAS) - (06/04)

Page: 5 of 6

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: WANG FAMILY CHILD CARE	FACILITY NUMBER: 198021437
	VISIT DATE: 03/27/2024

NARRATIVE

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The following corrections need to be corrected prior to obtaining a large family child care license. Corrections are due by 03/29/2024:
1. Applicant will provide receipt of fire extinguisher.
2. Applicant will provide proof of additional safety gate to kitchen.
3. Applicant will provide proof of additional safety gate to the side yard.

A large family child care license will be granted upon receipt of proof of corrections for the above. Once licensed, the applicant is required to adhere to the terms and limitations stated on the license. A copy of this report and all other Licensing reports must be made available to the public for 3 years.

The applicant’s signature on this report acknowledges that they have signed the Application for a Family Child Care Home License (LIC 279) under the penalty of perjury that the statements on the application and any attachments are correct.

Exit interview was conducted with Shunan (Joyce) Wang, Applicant at 1515 S. 3^rd Ave., Arcadia, CA 91006. who is in agreement with the above.

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SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Nolan Tcheng
LICENSING EVALUATOR SIGNATURE:	DATE: 03/27/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2024

LIC809 (FAS) - (06/04)

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