Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198018431
Report Date: 01/14/2016
Date Signed 01/19/2016 09:41:33 AM

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:CAO & CHIANG FAMILY CHILD CAREFACILITY NUMBER:
198018431
ADMINISTRATOR:CAO,LING YAN & CHIANG,BOBFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 513-0168
CITY:ARCADIASTATE: CAZIP CODE:
91007
CAPACITY:14CENSUS: 5DATE:
01/14/2016
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
02:40 PM
MET WITH:Bob ChiangTIME COMPLETED:
03:30 PM
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Licensing Program Analysts Brandi Van Oosten and Seung Lee conducted a Plan of Correction visit today to ensure that the deficiencies cited on 12/15/15 have been corrected. LPAs met with Bob Chiang, Licensee during this visit. Mr. Chiang states that he is no longer working and is present during operating hours and if he does leave, Ling Yan Cao is present.

The licensee have corrected all deficiencies noted on the report dated 12/15/15. Peng Yun Wang and Ja-Hye Pang have both obtained criminal record clearances and are associated to the facility.

Based on the information provided and LPAs observation. The deficiencies issued on 12/15/15 have been corrected and are being cleared today. A Letter of Deficiency Citations Cleared was provided to the licensee during this visit.

Children's records were reviewed and the required Acknowledgement of Receipt of Licensing Reports form (LIC 9224) was on file for children present during this visit. LPA issued the Confidential Names List (LIC 811) to the licensee during this visit. The Confidential Names List (LIC 811) documents the staff and/or children’s files that were reviewed during this visit.

At this time, the licensee is in compliance with Title 22 Regulations.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

Exit interview conducted with Bob Chiang, Licensee.
SUPERVISOR'S NAME: Bertha ManzanaresTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Brandi VanOostenTELEPHONE: (323) 854-8930
LICENSING EVALUATOR SIGNATURE:

DATE: 01/14/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2016
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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