Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198018431
Report Date: 06/26/2017
Date Signed 06/26/2017 02:21:03 PM


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/16/2017 and conducted by Evaluator Anomeh Eivazian
PUBLIC
COMPLAINT CONTROL NUMBER: 33-CC-20170616153741
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: 12DATE:
06/26/2017
UNANNOUNCEDTIME BEGAN:
11:59 AM
MET WITH:Yan Ling Cao and Bob Chiang, licenseesTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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Facility is over capacity
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Anomeh Eivazian conducted an unannounced 10 day complaint inspection to attempt to investigate the above allegation. Upon arrival, LPA met with Yan Ling Cao and Bob Chiang, Licensees. LPA toured the facility with Mr. Chiang. During this inspection there were 12 children present, 2 being infants. Licensees assistant, JingJing Li was also present in the home during this inspection. Licensees two biological children were also present in the home.

During the course of the investigation interview was conducted with licensee, Yan Cao.

The LPA obtained a current children’s roster of the facility, sing in/out for week of 06/11/17, and Option - Food Program visit form dated 06/16/17.


REPORT CONTINUES ON THE NEXT PAGE 1 OF 2
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Anomeh EivazianTELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2017
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 33-CC-20170616153741
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
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 CARE
FACILITY NUMBER: 198018431
VISIT DATE: 06/26/2017
NARRATIVE
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Based on an interview conducted with licensee, Yan Cao on 06/16/17 there were total of 14 children present in the facility, two being infants and 12 being preschoolers.

Based on LPA’s observations and interviews which were conducted and record reviews, the preponderance of evidence standard has been met, therefore the above allegation is founded to be SUBSTANTIATED at this time.

The following is being cited in accordance to Title 22 of the California Code of Regulations and Health & Safety Codes. Please refer to 9099D for documentation of deficiencies.

Upon receipt of this report, the Licensee shall post the Notice of Site visit and any licensing report documenting a type “A” deficiency. The report and the Notice of Site visit shall be posted for 30 consecutive days. Failure to maintain posting as required, will result in an immediate $100 civil penalty. A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled children for the next 12 months (1 year). The Acknowledgement form must be maintained in each child’s file immediately upon receipt from parent. Licensee was provided with a copy of the parent Acknowledgement of Receipt of Licensing Reports Form during this inspection.


LPA advised the Licensee to access forms and regulations on line at: www.ccld.ca.gov

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 was conducted with Licensees, Yan Ling Cao and Bob Chiang. Appeal Rights procedures explained.

REPORT END 2 of 2
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Anomeh EivazianTELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2017
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 33-CC-20170616153741
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
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 CARE
FACILITY NUMBER: 198018431
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/26/2017
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/26/2017
Section Cited
102416.5(a)
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Staffing Ratio and Capacity.

The capacity specified on the license shall be the maximum number of children for whom care can be provided.
On 06/16/17 there were 14 children present
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Per Licensees, two children were dropped from program effective 06/16/17, and currently 12 children are enrolled, 2 being infants.

LPA provided licensees Capacity Handout (Small & Large).
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in the facility, two of them being infants and 12 preschoolers.

This is an immediate health and safety risk to the children in care.
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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: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Anomeh EivazianTELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2017
LIC9099 (FAS) - (06/04)
Page: 3 of 3