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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304313990
Report Date: 10/09/2023
Date Signed: 10/09/2023 11:01:41 AM

Document Has Been Signed on 10/09/2023 11:01 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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:MONDINO, MENGDIFACILITY NUMBER:
304313990
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
10/09/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Mondino, Menngdi, Licensee.TIME COMPLETED:
11:30 AM
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LPA Vivian Trinh conducted and unannounced case management inspection on 10/9/23. LPA met with licensee Mondino, Mengdi, and toured the facility. At the time of inspection there were no children present due to the holiday (Columbus Day).All areas identified on the facility sketch were inspected, including but not limited to, off-limit areas. This is a single-story outcome adjoining the main house. The new home ADU is built in the backyard, got a permit, and also got approved by the fire department with the required permits of the City guidelines.
The outhouse is the designated Family Child care home while the main house is a two story family home with 4 bedrooms, 2 ½ and half bathrooms, family room, living area with dining area, kitchen, laundry room, attached garage, covered patio , back yard with two side yards.
The ADU is built at the back of the main house is a daycare area. Daycare children gate entrance is on the right-hand side (wooden). Facility ADU is a single home with 2 bedrooms and 1 children's bathroom. The licensee has designated the living room which is a study room and eating room for daycare children. Across from the living room is a kitchen with each of the cabinets with safety latch. The Stove also has a stove knob. Next to the living room is room number 1st bedroom, The licensee identified that room will be a nap room for all children in daycare that will include infants. Licensee status while children nap time licensee will stay in the front of the door. Across from the nap room is a children’s bathroom with a step tool. The last room is a 2nd bedroom, licensee identified that room is children's playroom activities. Across the 2nd room is storage, the licensee status that is storage supplies for children such as toys, blankets, pillows etc. Licensee status will be locking all the time when operation hours. Licensee also put the safety doorknob on the storage door. Room number 2 also have a sliding glass door leads into the yard; however, licensee status will be lock all the time. Children will entrance in the front door of ADU leads into the children play yard. Between the main house and the ADU has a children gate that is separate their main house and children daycare area.

Cont Page 2
SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Vivian Trinh
LICENSING EVALUATOR SIGNATURE: DATE: 10/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/09/2023
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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: MONDINO, MENGDI
FACILITY NUMBER: 304313990
VISIT DATE: 10/09/2023
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Outdoor play activities will be conducted in the backyard. The backyard is appropriately fenced. LPA observed age-appropriate play equipment to be free from hazards. There are no bodies of water on the premises. LPA informs the Licensee after each of water activities for the children, the licensee needs to throw all the water out.

The off-limits areas are the main house area. Main house area One two story house. Frist story has 4 bedroom and 2 ½ bathroom. Garage and Livingroom, kitchen, and Landry room. Licensee status children not entire to the main house, and licensee status will be locking means of child safety latch while operation hours.

Detergents, cleaning compounds, medicines, sharp objects, and hazardous items that can pose a danger to children are inaccessible in areas designated for children. The applicant stated that there are no poisons on the premises and LPA did not observe any. The applicant was advised that any poisons must be locked with a key or combination lock. The applicant stated that there are no weapons or firearms on the premises. The LPA informed the applicant that when firearms are present, they must be locked and stored separately from the ammunition per CCR 102417(g)(4)(C).

The pressure gauge on the 2A-10BC fire extinguisher(s) indicates fully charged, as indicated on the service tag observed. Smoke and carbon monoxide detectors were tested and are operable. 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. The pressure gauge on the 2A-10BC fire extinguisher(s) indicates fully charged, as indicated on the service tag observed on the top of the refrigerator
The applicant stated she would not provide food for the children. Licensee status she only provide snack to the children with the parents provided. The applicant was informed that if children bring food from home, the children’s names must be labeled on their lunch bags and refrigerated/stored properly.

Cont Page 3
SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Vivian Trinh
LICENSING EVALUATOR SIGNATURE:

DATE: 10/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2023
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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: MONDINO, MENGDI
FACILITY NUMBER: 304313990
VISIT DATE: 10/09/2023
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The licensee has a cell phone to use for childcare. LPA informed the licensee that the cell phone must always remain on the premises during hours of operation from Monday-Friday 8:30am-6:00pm. The licensee stated that she provide snacks only. The license stated if children have allergies depending on allergy, they will substitute the food or parents will have to bring the food depending on the allergy. The licensee stated that the home is free from smoking during hours of operation. Cleaning solutions/chemicals, utensils, and sharp knives located in the kitchen are all inaccessible by child safety locks. Poisons/Hazardous items are not stored on site, and none were observed

INFORMATION TO BE POSTED IN YOU FAMILY CHILD CARE HOME – You are required by law to post the following:

Facility License (LIC 203), Waivers (if applicable), Notification of Parent’s Rights Poster (PUB 394), Earthquake Preparedness Checklist (LIC 9148), Emergency Disaster Plan (LIC 610A) California Car Seat Law (PUB 269). ). A Notice of Site Visit (LIC 9213) must be posted 30 days after each site inspection by a Licensing Representative. Any Licensing Report documenting a Type “A” deficiency must be posted for 30 days during the hours that children are in care. Any Licensing Report or other document verifying compliance or non-compliance with the Department’s order to correct a Type “A” deficiency must be posted for 30 days during the hours that children are in care.

LPA reviewed Unusual Incident Report (UIR) form (LIC 624B)-advised to contact Licensing Officer of the Day within 24 hours and complete the UIR within seven days by faxing LIC624B to (714)703-2831. LPA advised applicant to report to licensing any unusual incident or child absence that threatens the physical or emotional health or safety of any child or any changes to hours and days of operation and for any changes to facility, including on/off limit areas and change in phone number.

LPA reviewed with licensee requirements of Disaster Preparedness drills (documented every 6 months). The LPA advised of Affidavit Regarding Liability Insurance (LIC 282) if did not purchase liability insurance and to maintain the form in the children's files, and Car Safety Seat pamphlet were discussed and provided to the applicant.

Cont page 4

SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Vivian Trinh
LICENSING EVALUATOR SIGNATURE:

DATE: 10/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2023
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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: MONDINO, MENGDI
FACILITY NUMBER: 304313990
VISIT DATE: 10/09/2023
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The licensee has completed the Mandated Reporter Training for self and 03/2024. Department web site form was given to download forms, Title 22 regulations, and trainings on-line at http://www.ccld.ca.gov. The licensee has registered to obtain quarterly updates and notifications from the Department. Child Care Advocate contact information: childcareadvocatesprogram@dss.ca.gov. was provided. LPA reviewed Title 22 Regulation Section 102423 Personal Rights including but not limited to: no intimidation, no humiliation, and no corporal punishment. A copy of “A Child Care Providers Guild to Safe Sleep” was provided to applicant: English:

Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPAs also informed the applicant 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.


The applicant was given a pamphlet on Lead Exposure and was discussed with the provider. Also provided was information about the E-Learning Modules available at https://ccld.childcarevideos.org. The Chapter Legislation for AB 2084 (Nutritious Beverages) is available to view on the website at: http://ccld.ca.gov/res/pdf/12APX-11.pdfAppeal Rights and the appeal rights process was discussed with the applicant. The applicant was informed all appeals must be in writing and received by the licensing office within 15 business days.

An exit interview conducted where the report was reviewed with the applicant. The Notice of Site Visit was posted and discussed as required by H&S Code Sec. 1596.817. Notice of Site Visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100.00. The Notice of Site Visit must be posted on or adjacent to the door.

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SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Vivian Trinh
LICENSING EVALUATOR SIGNATURE:

DATE: 10/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2023
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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: MONDINO, MENGDI
FACILITY NUMBER: 304313990
VISIT DATE: 10/09/2023
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The Small Family Child Care Home was in compliance with Title 22 Regulations at the time of inspection. In the event additional requirements are needed, the applicant will be notified.

Appeal rights were provided, and an Exit Interview was conducted with applicant Mondino, Mengdi.

The operation hours are from 7:00am to 6:00pm Monday through Friday for ages 1months – 5 years.

This report ends here.

SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Vivian Trinh
LICENSING EVALUATOR SIGNATURE:

DATE: 10/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2023
LIC809 (FAS) - (06/04)
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