197413708-12-12-2019-12-CC-JNEL-BJSP8T-20191212100602

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197413708
Report Date: 12/12/2019
Date Signed: 12/12/2019 10:06:13 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME:	LEE FAMILY CHILD CARE		FACILITY NUMBER:	197413708
ADMINISTRATOR:	LEE, YEUN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(661) 263-8074
CITY:	VALENCIA	STATE: CA	ZIP CODE:	91354
CAPACITY:	10	CENSUS: 6	DATE:	12/12/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Yeun Lee		TIME COMPLETED:	10:20 AM

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) Neal met with licensee, Yeun Lee and conducted an unannounced annual/random inspection of the home. LPA observed 6 child care children present at the facility. This is a two story home with a living room, family room, kitchen, dining room, 3 bathrooms, office and laundry room and garage. Garage is used for storage only and no child care activities are conducted there. The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children. Main care is provided in the living room/dining room. Children use the downstairs bathroom. LPA observed safety locks on cabinet under sink. The off limits areas are kitchen, family room, garage and the entire upstairs area. Laundry is upstairs in off limits area. The stairs were observed gated. Licensee has central air conditioning and heat. The LPA observed safe toys and play equipment in good condition. Cleaning solutions, medications, and knives are stored in the off limits gated kitchen and garage. The fireplaces are screened. Fire extinguisher, smoke and carbon monoxide detectors were observed in operable condition. The licensee's pediatric CPR and First Aid expires 02/2021. Required documents were observed posted. The licensee has all the required immunizations. The LPA observed a current children's roster. Children's files were reviewed and found to be complete. Fire and disaster drills are also current.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Jazelle Neal	TELEPHONE: (661) 568-8945
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2019

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
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME: LEE FAMILY CHILD CARE	FACILITY NUMBER: 197413708
	VISIT DATE: 12/12/2019

NARRATIVE

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Children play in the backyard. The outdoor play area was inspected and was observed to be free of hazards, loose and sharp parts. There are no bodies of water on the premises. Per the licensee there are no weapons or firearms of any kind in the facility at this time. The LPA did not observe any weapons. Licensee has equipment of napping. A sample of children's files was reviewed.

The following were discussed with the licensee: The LPA also discussed earthquake safety and necessity of drills, required forms for children’s files, facility files and posting requirements. Regulation prohibits the smoking of tobacco in a private residence that is licensed as a family child care home and in those areas of the family child care home where children are present (24/7 ban).The licensee was advised how to access forms and Regulations for Family Child Care online at www.ccld.ca.gov. State law prohibits baby walkers, bouncy seats, exersaucers and any other items that fall into that category.

Requirements for fingerprint clearances and associations were discussed with the licensee. Licensee can be cited a civil penalty of $100 per day, up to $500.00 for the 1^st offense and up to $3000.00 for the 2^nd offense within a 12 month period, PER PERSON.

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

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Jazelle Neal	TELEPHONE: (661) 568-8945
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2019

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
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME: LEE FAMILY CHILD CARE	FACILITY NUMBER: 197413708
	VISIT DATE: 12/12/2019

NARRATIVE

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Licensee was advised of the requirement to report unusual incidents and/or injuries to the parent/guardian and Licensing within the time frame specified by the regulation and on the form LIC624B. Handout on Safe Sleep concepts was given and discussed.

Licensee was advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. If a serious violation is cited, a copy of the licensing report (LIC809 or LIC9099) must also be posted for 30 days. If these requirements are not met, civil penalties in the amount of $100 per violation will be assessed. Copies of the reports must also be provided to each parent and a copy of the Acknowledgment of receipt of licensing report (LIC9224) must be kept in each child's file. In addition, any child enrolled within the following 12 months must also receive a copy of the Type A Citation.

No deficiencies were cited during this inspection.

Exit interview was conducted, report was read and a copy was provided to licensee on this date.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Jazelle Neal	TELEPHONE: (661) 568-8945
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2019

LIC809 (FAS) - (06/04)

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