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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197416161
Report Date: 01/09/2020
Date Signed: 01/09/2020 10:59:32 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:YI FAMILY CHILD CAREFACILITY NUMBER:
197416161
ADMINISTRATOR:YI, MIKYONGFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 373-9856
CITY:LOS ANGELESSTATE: CAZIP CODE:
90019
CAPACITY:14CENSUS: 11DATE:
01/09/2020
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Yi, MikyongTIME COMPLETED:
11:15 AM
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On 01/09/2020 at 9:30 am, Licensing Program Analyst (LPA) Lourdes Castellanos conducted an unannounced visit for the purpose of conducting a annual site visit at the Yi Family Child Care. LPA met with Licensee Mikyong Yi and Licensee’s husband, Nam Kook Park who assist with some translation (Korean) who guided LPA on a tour of the facility inside and out. Upon arrival, LPA observed 11 children in care being supervised by two teachers. Facility is license for a capacity of 14 children. Facility is operating within capacity limitations All adults were fingerprinted and associated to the facility. LPA Castellanos toured and inspected all rooms identified in facility sketch. Hours of operation are from 8:00 am to 6:00 pm, Monday through Friday. Family members residing in the home include licensee and spouse and adult daughter.

The home is a two story dwelling with 5 bedrooms, 5 baths, living room, dining room, family room, kitchen, gated front and backyard. Licensee utilizes the living room, dining room and family room (which is located on the other side of the stairwell) Bedroom #1 is used !for the children's activity and nap areas. age appropriate napping equipment and materials available and inspected (mats). The stairway is properly barricaded. There is also a safety gate blocking entry into the kitchen area. Children use the bathroom located at the rear of the Bedroom #1 . LPA inspected the bathroom and did not observe any cleaning compounds, medications or toxins accessible to children in care, safety. Off limit areas include the home’s bedrooms upstairs # 3, #4 and #5., and 3 bathrooms upstairs.
The facility was inspected inside and outside for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds (under sink with latch), and hazardous items that can pose a danger to children. LPA observed age appropriate toys, learning materials, games and activities for children in care. All furniture was found in good repair, clean, and without hazards. Inspection of the outdoor play area is conducted. Age appropriate play equipment is found to be securely anchored with adequate resilient cushioning material underneath and around the perimeter. There is no pool, spa or other bodies of water on the premises. Licensee stated that there are no firearms kept on the premises and no pets. Cont'd page #2
SUPERVISOR'S NAME: Victor BautistaTELEPHONE: (424) 301-3008
LICENSING EVALUATOR NAME: Lourdes CastellanosTELEPHONE: (424) 301-3066
LICENSING EVALUATOR SIGNATURE:

DATE: 01/09/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2020
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: YI FAMILY CHILD CARE
FACILITY NUMBER: 197416161
VISIT DATE: 01/09/2020
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There is a fire extinguisher (2A10BC) mounted in the children's area and an operable smoke/carbon monoxide detector was observed, tested and operable at the time of inspection. First Aid kit and earthquake supplies were observed. All unused electrical outlets are covered with safety covers. The home has central heating/air. First Aid/CPR requirements are met by licensee with an expiration of 10/2020. Incidental Medical Services were discussed with the licensee, they will not be provided at this time. The facility annual fees are current. Licensee had all the required posted documents: Facility License (LIC 203), Notice of Parent's Rights Poster (PUB 394), Emergency Disaster Plan (LIC 610A), and Earthquake Preparedness Checklist (LIC 9148). (5- Children files /reviewed and were found to be complete (see LIC811) . LPA observed a current facility roster.

The following was discussed with the licensee: Mandatory Forms for the children’s files and provider’s files, Requirements for fire drills, earthquake drills, and documentation for both. The role and responsibilities of being a mandated reporter were discussed. The licensee was advised how to access forms and Regulations for Family Child Care online at www.ccld.ca.gov. Licensee was made aware that it is their responsibility to know the regulations as well as anyone who assists in providing care. The licensee was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care. Licensing must always have the facility’s phone number. If the phone number has changed, licensing must be notified.
There is an effective 24/7 ban on smoking tobacco in a home that is licensed as a family day care home, and in those areas of the family day care home where children are present.

The licensee was informed of the role and responsibilities of being a mandated reporter, renewal required every 2 years for a licensed child care provider, administrator, or employee ( www.mandatereporterca.com )
Licensee completed mandated reporter training on 5/1/2018.

State law prohibits baby walkers, bouncy seats, exer-saucers and any other items that fall into that category. All infants must be placed on their backs when sleeping to prevent S.I.D.S. (Sudden Infant Death Syndrome). The provider is required to wash hands after every diaper change and to never shake a baby to prevent Shaken Baby Syndrome. Only children eating may be in high chairs and that car seats are utilized only for transportation.

Cont'd page 3

SUPERVISOR'S NAME: Victor BautistaTELEPHONE: (424) 301-3008
LICENSING EVALUATOR NAME: Lourdes CastellanosTELEPHONE: (424) 301-3066
LICENSING EVALUATOR SIGNATURE:

DATE: 01/09/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2020
LIC809 (FAS) - (06/04)
Page: 2 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: YI FAMILY CHILD CARE
FACILITY NUMBER: 197416161
VISIT DATE: 01/09/2020
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Sleep Links:
AAP:https://www.healthychildren.org/English/ages-stages/baby/sleep/Pages/A-Parents-Guide-to-Safe-Sleep.aspx
NIH: https://safetosleep.nichd.nih.gov/safesleepbasics/environment/room/text_alternative Safe to Sleep Campaign: https://safetosleep.nichd.nih.gov/materials

AB 1207: Beginning on January 1, 2018, this law requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Volunteers are encouraged but not required to take the training. Website: www.mandatedreporterca.com



Senate Bill 792: this bill, commencing September 1, 2016, prohibits a person from being employed or volunteering at a child care facility or family day care if he or she has not been immunized against influenza, pertussis and measles.
New Immunization Requirement: Law enacted by SB 277, beginning January 1, 2016, personal beliefs exemptions will no longer be an option for the vaccines that are currently required for entry into child care or school in California. Personal beliefs exemptions already on file will remain valid until the child reaches the next immunization checkpoint.

Nutrition Requirement: Beginning January 1, 2016, AB 290 will require for each new license issued, at least one director or teacher at each child care center or family child care home to have at least one hour of training in the importance of childhood nutrition. This applies to anyone submitting a new application, relocating their facility, selling their facility or transferring their license. Please note this training cannot be completed online or by home study programs. The training must be taken from an Emergency Medical Services Authority (EMSA) approved training program OR an accredited college or university.
Update on Incidental Medical Services (IMS):
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. Cont'd page 4i
SUPERVISOR'S NAME: Victor BautistaTELEPHONE: (424) 301-3008
LICENSING EVALUATOR NAME: Lourdes CastellanosTELEPHONE: (424) 301-3066
LICENSING EVALUATOR SIGNATURE:

DATE: 01/09/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2020
LIC809 (FAS) - (06/04)
Page: 3 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: YI FAMILY CHILD CARE
FACILITY NUMBER: 197416161
VISIT DATE: 01/09/2020
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IMS Include: Blood-Glucose Monitoring for Diabetic Children, Administering Inhaled Medication, Administering Epinephrine Auto-Injectors, Glucagon Administration, Gastrostomy Tube Care (G-tube care), Insulin Injections Administration, Anti-Seizure Administration, and Emptying an Ileostomy Bag.
Incidental Medical Services (IMS) policy was discussed. For further 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
Currently, the facility does not provide Incidental Medical Services - IMS.

LPA discussed capacity limitations, new car seat law, personal rights, Notification of Parent's Rights revised 12/06, inspection authority & agency's consultative role. Smoking is prohibited on the premises when children are present. The LPA also discussed earthquake safety and necessity of drills every 6 months. The licensee was also informed that all adults living in or having access to day care children in the home are required to have fingerprint clearances with Department of Justice, FBI and Child Abuse Index prior to having contact with children. If the aforementioned is not adhered to, a Civil Penalty of $100 /day per uncleared adult will be assessed.

The licensee was informed of The Child Care Advocate Program (CCAP) that is administered from within the Community Care Licensing Division. CCAP participates in many community activities and special projects in order to disseminate information on the State’s licensing role, provide information to the public and parents on child care licensing, and provide many other helpful resources to the licensees and the public. CCAP’s direct contact information is as followed: Phone number: (916) 654-1541.


Email Address: childcareadvocatesprogram@dss.ca.gov

The Facility was found to be in compliance per Title 22 Regulations. There were no citations issued during this visit. An exit interview was conducted and a copy of this report along with the notice of site visit were provided to Licensee.

SUPERVISOR'S NAME: Victor BautistaTELEPHONE: (424) 301-3008
LICENSING EVALUATOR NAME: Lourdes CastellanosTELEPHONE: (424) 301-3066
LICENSING EVALUATOR SIGNATURE:

DATE: 01/09/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2020
LIC809 (FAS) - (06/04)
Page: 4 of 4