197418702-8-15-2019-30-CC-KSTS-BF3N48-20190815100731

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197418702
Report Date: 08/15/2019
Date Signed: 08/15/2019 10:08:30 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:	KIM FAMILY CHILD CARE		FACILITY NUMBER:	197418702
ADMINISTRATOR:	HYUN JU KIM		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(213) 610-5056
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90019
CAPACITY:	14	CENSUS: 12	DATE:	08/15/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:35 AM
MET WITH:	Ju Kim Hyun		TIME COMPLETED:	10:15 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	On 09/15/19 at 08:35 am, Licensing Program Analyst (LPA) Karren Starks made an unannounced visit for the purpose of conducting an Annual/Random inspection. LPA met with licensee Ju Kim Hyun who had 12 children in a care at the time of inspection. Two of the children are the licensee's (ages 2 & 5 yrs), with assistance from the licensee's Mother and Father in law who have Criminal Record Clearances. LPA and licensee toured the facility (licensee's primary language is Korean, but she understands English). Areas inspected were inside and outside which appeared to be clean, safe and well ventilated. The home is a two story 4 bd 3 ba family home. The home includes a living room, dining room and laundry area. Bedroom #1 is downstairs and is the care and play area for the infants in care. The additional bedrooms in the home are located upstairs which are made inaccessible by a safety gate. Main care is provided in the living room and the bathroom for children in care is located next to the infant room. The entrance to the facility is through the front door and the infant parents have a separate entrance, just to the right of the main entrance. All other areas of the home that are off limits to children in care are made inaccessible by child safety gates. The licensee, her husband and his parents live in the home. A fully charged fire extinguisher was observed in teh dining room, there are operable smoke/carbon monoxide detectors present in the home. LPA observed a drill log for Fire and Emergency drills. All hazardous items inaccessible & Toxins locked. Home has central heating and the vents are screened and inaccessible to children in care. Licensee had required postings. No guns or weapons present as stated by the applicant. LPA did not observe any weapons Control of property verified by viewing rental agreement . Napping equipment observed. There are no pets. License, Facility Sketch, Earthquake Preparedness Checklist and Emergency Disaster Plan are posted. No bodies of water present. Outdoor area is free of debris. The licensee utilizes the front yard for play and the gate is closed when the children go out of play. LPA inspected the area and did not observe any debris nor hazards that would pose a risk to children in care. CPR/First Aid are current for licensee with an expiration of 09/2020.

SUPERVISOR'S NAME: Jennie Ferreira	TELEPHONE: (424) 301-3067
LICENSING EVALUATOR NAME: Karren Starks	TELEPHONE: (424) 301-3069
LICENSING EVALUATOR SIGNATURE:	DATE: 08/15/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2019

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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: KIM FAMILY CHILD CARE	FACILITY NUMBER: 197418702
	VISIT DATE: 08/15/2019

NARRATIVE

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LPA reviewed children's records and found them to be complete. The licensee and staff do not have Mandated Reporter Training at this time due to Korean being their primary language.

Senate Bill (SB) 277 New Immunization Requirement: 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.

Licensee was made aware 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

Update on Incidental Medical Services: Facilities that provide Incidental Medical Services (IMS) must identify those services in their facility’s Plan of Operation and submit an updated Plan of Operation 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
Incidental Medical Services Include: Blood-Glucose Monitoring for Diabetic Children, Administering Inhaled Medication, Administering EpiPen Jr. and EpiPen or other Epinephrine Auto-Injectors, Glucagon Administration, Gastrostomy Tube Care (G-tube care), Insulin Injections Administration, Anti-Seizure Administration, and Emptying an Ileostomy Bag

No deficiencies cited.

Exit interview conducted, Notice of Site visit issued, copy of report given.

SUPERVISOR'S NAME: Jennie Ferreira	TELEPHONE: (424) 301-3067
LICENSING EVALUATOR NAME: Karren Starks	TELEPHONE: (424) 301-3069
LICENSING EVALUATOR SIGNATURE:	DATE: 08/15/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2019

LIC809 (FAS) - (06/04)

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