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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197414826
Report Date: 09/29/2022
Date Signed: 09/29/2022 03:04:13 PM


Document Has Been Signed on 09/29/2022 03:04 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245



FACILITY NAME:PARK FAMILY CHILD CAREFACILITY NUMBER:
197414826
ADMINISTRATOR:PARK, CHAN G.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 737-3481
CITY:LOS ANGELESSTATE: CAZIP CODE:
90019
CAPACITY:14CENSUS: 3DATE:
09/29/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:CHAN PARK, LICENSEETIME COMPLETED:
03:30 PM
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On 09/29/2022 Licensing Program Analyst (LPA), Lisa Clayton, conducted an unannounced Annual inspection and was met by Licensee, Chan Park and her son Daniel Park who translated due to the language barrier (licensee speaks Korean). LPA Clayton observed 3 children in care today being supervised and care for appropriately. Operating hours are Monday – Friday, 7am – 6pm. Licensee will provide breakfast, lunch, snack and dinner.

LPA Clayton toured the inside and outside of the home for a Health and Safety inspection. The single family home consists of the following: 3 bedrooms, 3 bathrooms, living room, family room, dining room, enclosed patio, kitchen, detached garage and fenced back yard.

The ON LIMIT areas are as follows: living room (day care room), dining room (day care eating area), enclosed patio (day care paly area), family room (class/nap room), bedroom #1 (infant room) and the fenced backyard.

The OFF LIMIT areas are: bedrooms #2, and #3, bathroom #2 and #3, and the kitchen, all of which are made inaccessible by locked doors, child safety door handles, and supervision.

There is a fully charged 3:A:10:BC fire extinguisher in the living room. A Fire Clearance was issued in February 2016 by the City of Los Angeles. The facility has a working carbon monoxide detector and 3 working smoke detectors. The facility has adequate heating and ventilation for safety and comfort. There are no stairs in the home. Safe toys and play equipment are observed. The home has working telephone service and LPA confirmed the phone number is (323) 737-3481.

The Per the licensee, there are no firearms in the home. There are no swimming pools, ponds or other bodies of water on the property. Any detergents, cleaning compounds, medication, poisons and other hazardous items are made inaccessible to children.

Licensee ensures that children in care are supervised at all times and is aware children shall not be left in parked vehicles. Car seats are used for transportation purposes only and are not used for sleeping children. Capacity as specified on the license is being maintained.

Licensees pediatric CPR/First Aid certificate expires December 2023. A review of records indicates that Licensee is in compliance with the immunization laws pertaining to childcare providers.

SUPERVISOR'S NAME: Karren StarksTELEPHONE: (424) 301-3069
LICENSING EVALUATOR NAME: Lisa ClaytonTELEPHONE: (424) 301-3067
LICENSING EVALUATOR SIGNATURE:
DATE: 09/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/29/2022
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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: PARK FAMILY CHILD CARE
FACILITY NUMBER: 197414826
VISIT DATE: 09/29/2022
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Incidental Medical Services (IMS) are not being provided at this time. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. LPA Clayton provided licensee with an IMS Plan sample. 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

For licensing updates email childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of 100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Licensee is currently caring for 1 infant. LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep web page at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee 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.

Licensee will provide proof of Mandated Reporter training for her and her assistant no later than Tuesday October 4, 2022.

No deficiencies were cited today, Per Title 22, Division 12, Chapter 3, of the California Code of Regulations.

An exit interview was conducted, a copy of this report was read and provided to the Licensee Chan Park. This report shall me made available to the public upon request. LIC 9213 Notice of Site Visit was provided and required to be posted for 30 days.

SUPERVISOR'S NAME: Karren StarksTELEPHONE: (424) 301-3069
LICENSING EVALUATOR NAME: Lisa ClaytonTELEPHONE: (424) 301-3067
LICENSING EVALUATOR SIGNATURE:

DATE: 09/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2022
LIC809 (FAS) - (06/04)
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