<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400588
Report Date: 07/29/2022
Date Signed: 07/29/2022 11:30:47 AM

Document Has Been Signed on 07/29/2022 11:30 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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:ONG FAMILY CHILD CAREFACILITY NUMBER:
198400588
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: DATE:
07/29/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:05 AM
MET WITH:Sayra Ong, ApplicantTIME COMPLETED:
12:00 PM
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 Analyst (LPA) Katrina Chicote conducted an Announced – Prelicensing Inspection on 07/29/2022 at 9:05 AM to the above facility. LPA met with Sayra Ong, Applicant, and LPA was taken on a guided tour of the facility both indoors and outdoors. Adults in the home were discussed and all have criminal record clearance. The Applicant is requesting a small family child care home license. Per Applicant, operation hours will be Monday to Friday, 7:00am to 7:00pm.

All areas identified on the facility sketch were inspected, including but not limited to, off limit areas. This is a single-story home that consists of four bedrooms, two bathrooms, dining room, living room, kitchen, family room, attached garage, and backyard. Applicant states sick/isolation area will be Bedroom 1 (located down hallway to the left upon entry of the home). At 9:20am, LPA observed Bedroom 1 to have large queen bed and a futon available for children.

Per Applicant, the children will have access to Living Room (located to the right upon entry), Dining Room (located next to Living Room), Family Room (located to the rear of the home), Bathroom 1 (located through the left door, and a quick left down hallway), backyard, and Kitchen will only be used as a walkway to access backyard. Main Care Area will be the Living Room, Dining Room, Family Room, and Bathroom 1. Areas that will be used by children were inspected for safety, comfort, cleanliness, telephone service (cell phone and landline), ventilation and heating (central air and heat). At 9:06am, LPA observed a fireplace in the Living Room that is barricaded making it off limits to children. LPA observed large sofa, flat screen tv hanging, and shelves filled with games and toys available for children in Living Room. At 9:07am, LPA observed Dining Room to have rectangular table and six chairs, Applicant states she will provide food or children in care and that children will use this area for eating. At 9:08am, LPA observed Family Room to have computer desk in the back, child size tables and chairs, chaise lounge, and shelves with baskets that Applicant states will be used for more children's toys. Applicant states they are still in the process of purchasing more items for the home. The Applicant was advised that any
Report Continues - Page 1 of 5
SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE: DATE: 07/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/29/2022
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 5
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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: ONG FAMILY CHILD CARE
FACILITY NUMBER: 198400588
VISIT DATE: 07/29/2022
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
26
27
28
29
30
31
32
poisons such as detergents, cleaning compounds, and medicines must be made inaccessible or stored somewhere with a key or combination lock. LPA observed these items stored in a locked storage on the side of the house and LPA observed a basket in high cabinet in Kitchen for storage of medicines.

Based on the Facility Sketch submitted, areas off limits to children include attached garage, Bedrooms 2, 3, 4; and Bathroom 2 (located inside Bedroom 2). At 9:10am, LPA observed child safety covers on all off limits bedrooms and attached garage which will make it inaccessible to children. At 9:12am, LPA observed an operable retractable child safety gate blocking access to Kitchen, making it inaccessible when children are indoors. LPA observed Kitchen cabinets and drawers to all have operable child safety locks at time of inspection. LPA observed off limits areas at time of inspection.The Applicant understands that licensing staff may have access to off-limit areas during inspection visit if necessary.

At 9:14am, LPA observed a 21bs pound dog (Golden-Doodle breed) in a cage in attached garage. LPA observed vaccination records for dog at time of inspection.

Applicant states she has a firearm in the home that is stored in off limits Bedroom 2. At 9:20am, LPA observed firearm stored in a locked cabinet that required Applicant's fingerprint to open. LPA observed firing pin and ammunition stored separately in closet at time of inspection.

Per Applicant, the children will use the backyard for outdoor play. At 9:22am, LPA observed outdoor play is accessible through backdoor in Kitchen. LPA observed backyard has grass and adequate perimeter fencing through-out the yard. LPA observed a concrete area upon stepping out of backdoor that Applicant states will be primary area for outdoor play until future renovations. LPA observed dirt, dry grass rest of backyard, rose bushes, and various trip hazards in backyard. LPA discussed with Applicant that the rest of backyard needs to be made off limits and when renovations happen it needs to be reported to The Department.

At 9:30am, LPA observed the valve on the required 2A 10BC fire extinguisher indicates fully charged at time of inspection. Applicant states she purchased fire extinguisher last month but did not have receipt available at time of inspection. At 9:17am, LPA observed dual smoke and carbon monoxide detectors are in operable

Report Continues - Page 2 of 5
SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:

DATE: 07/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2022
LIC809 (FAS) - (06/04)
Page: 2 of 5
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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: ONG FAMILY CHILD CARE
FACILITY NUMBER: 198400588
VISIT DATE: 07/29/2022
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
26
27
28
29
30
31
32
condition at time of inspection. At 9:20am, LPA observed First Aid kit stored in Family Room and was inventoried for necessary supplies. The Applicant has current Pediatric First Aid and CPR and has completed the required Health and Safety Training, Nutrition, and Lead Training. Proof of immunization
against influenza, pertussis, and measles was readily available. The Licensee has also taken the Mandated Reporter Training
—CPR Card valid until: 06/14/2024
—Mandated Reporter AB1207 Completed: 06/16/2022

The following was discussed with the Applicant:
· Individuals who are 18 years of age or older living in the home must obtain a criminal record clearance. Individuals within one month of their 18th birthday must be fingerprinted immediately. Civil Penalties will be assessed if not in compliance.
· 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 Pediatric First Aid and CPR training, Immunizations (TDAP, MMR, Influenza), mandated reporter training and a valid criminal record clearance associated to the facility license.
· Annual fees must be paid promptly and by the due date or a late fee shall be assessed and/or the License may be terminated.
· The fire extinguisher type 2A-10BC must be serviced annually or as often as necessary. Smoke and carbon monoxide detectors should be checked and batteries replaced as needed.
· Reporting Requirements: 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.
· Reporting Requirements: Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing.
· 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 for a minimum of 3 years.
· No infant walkers, No Johnny jumpers, No saucer chairs, and any other item that falls into that category are not permitted in the facility.

Report Continues - Page 3 of 5
SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:

DATE: 07/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2022
LIC809 (FAS) - (06/04)
Page: 3 of 5
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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: ONG FAMILY CHILD CARE
FACILITY NUMBER: 198400588
VISIT DATE: 07/29/2022
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
26
27
28
29
30
31
32
·Inspection Authority: All adults living and working in the home shall be made of aware of the Department’s right to inspection the home, which includes, but is not limited to the right to enter the home when children are being cared for, interview children and adults and review documentation.
· The facility license number must be on all advertisements, publications or announcements with the intent to attract clients.
· Isolation for Ill children: When a child is ill he/she shall be separated from other children (reference 102417(e) Operation of a Family Child Care Home).
· Liability Insurance was discussed; LPA advised applicant to review Title 22 Regulation 102417(m)(1) for additional information.

· Immunization Requirement: H&S 1597.622: Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. The licensee and all adults working with children have proof of immunizations.

· Mandated Reporter Training: H&S 1596.8662: Beginning January 1, 2018, all licensed providers, applicants, directors and employees to complete training as specified on mandated reporter duties. Training is available at: www.mandatedreporterca.com

Infant Care: Applicant states that they will care for infants.


LPA discussed the safe sleep regulations with Applicant [or facility representative] 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 Applicant [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.

LPA advised the Applicant how to access forms, regulations and quarterly updates 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 forms referenced.

Report Continues - Page 4 of 5
SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:

DATE: 07/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2022
LIC809 (FAS) - (06/04)
Page: 4 of 5
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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: ONG FAMILY CHILD CARE
FACILITY NUMBER: 198400588
VISIT DATE: 07/29/2022
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
26
27
28
29
30
31
32
Incidental Medical Services (IMS):
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

OTHER INFORMATION AND FORMS PROVIDED:
· Capacity Handout for a Small Family Child Care Home and Large Family Child Care Home was provided.
· Handout for Lead poisoning

Per Applicant, there are no dual licenses at this address.

Based on the LPA’s observation, the following corrections need to be corrected prior to obtaining a small family child care license. Corrections are due by 08/05/2022.
  • Child safety lock on hallway closet
  • Make rear area of backyard off limits to children
  • Proof of receipt for fire extinguisher

A small family child care licensee will be submitted to Supervisor for review upon receipt of proof of corrections for the above. Once licensed, the Applicant is required to comply with the terms and limitations stated on the license. Proof of corrections may be submitted via email by correction date. A copy of this report was reviewed and provided to the Applicant.

Exit interview was conducted and report was reviewed with the Applicant (or facility representative), Sayra Ong.
Report Ends - Page 5 of 5
SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:

DATE: 07/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2022
LIC809 (FAS) - (06/04)
Page: 5 of 5