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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304313990
Report Date: 05/20/2024
Date Signed: 05/28/2024 04:24:25 PM

Document Has Been Signed on 05/28/2024 04:24 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
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:MONDINO, MENGDIFACILITY NUMBER:
304313990
ADMINISTRATOR/
DIRECTOR:		MONDINO, MENGDIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(949) 232-4711
CITY:LAKE FORESTSTATE: CAZIP CODE:
92630
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: DATE:
05/20/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:05 AM
MET WITH:Licensee - Mondino, MengdiTIME VISIT/
INSPECTION COMPLETED:
10:30 AM
NARRATIVE
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On 5/20/2024 at 9:05am, Licensing Program Analyst (LPA), Christine Jung and Licensing Program Manager (LPM), Martha Malane, conducted an unannounced case management inspection for the purpose of amending a report dated 5/14/2024. Upon arrival, LPA met with Licensee, Mondino, Mengdi and took a census. There were seven (7) children including three (3) infants being supervised by the licensee. At 9:10am, LPA observed one (1) additional child being dropped off, bringing the census to eight (8) children with the licensee; see LIC 809D for Type A deficiency cited,

LPA, Christine Jung, informed licensee, Mondino, Mengdi, that this report dated 5/20/2024 documents one (1) Type A citation. The facility was cited for exceeding limitations on capacity. Type A citations shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care.

Also, LPA, Christine Jung, informed the licensee to provide a copy of this licensing report dated 5/20/2024 that documents a Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Exit interview conducted and report was reviewed with the licensee Mondino, Mengdi. Appeal Rights and Notice of Site Visit were given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

End of Report.

SUPERVISORS NAME: Martha Malane
LICENSING EVALUATOR NAME: Soo Jin Jung
LICENSING EVALUATOR SIGNATURE: DATE: 05/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/20/2024
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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Document Has Been Signed on 05/28/2024 04:24 PM - It Cannot Be Edited


Created By: Soo Jin Jung On 05/20/2024 at 09:42 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: MONDINO, MENGDI
FACILITY NUMBER: 304313990

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/20/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/21/2024
Section Cited
CCR
102416.5(e)

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Staffing Ratio and Capactiy 102416.5(e)
If no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home as specified in subsections (b) and (c).
This requirement is not met as evidenced by:
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At 9:40am, licensee stated that she called a parent to ensure that they would not drop off additional children. At 9:53am, licensee's assistant arrived at the facility, and the facility was in compliance.
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Based on interview and observation, the licensee did not comply with the section cited above in that licensee was alone caring for 8 children three of whom were infants and none of the children were 6 years old or enrolled in public school, which poses a potential health, safety or personal rights risk to persons in care.
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Licensee stated that if her assistant will not be present, she will communicate with parents to coordinate drop off times which will prevent the facility from being over capacity.

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Martha Malane
LICENSING EVALUATOR NAME:Soo Jin Jung
LICENSING EVALUATOR SIGNATURE:
DATE: 05/20/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/20/2024


LIC809 (FAS) - (06/04)
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