<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197493415
Report Date: 07/21/2021
Date Signed: 07/21/2021 04:38:17 PM

COMPREHENSIVE INSPECTION
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:KWON FAMILY CHILD CAREFACILITY NUMBER:
197493415
ADMINISTRATOR:KWON, YONG JINFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(213) 434-8552
CITY:LOS ANGELESSTATE: CAZIP CODE:
90019
CAPACITY:14CENSUS: 21DATE:
07/21/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:40 AM
MET WITH:Yong KwonTIME COMPLETED:
04:45 PM
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 July 21, 2021 Licensing Program Analysts (LPAs), Veronica Wheatley and Lillian Casillas conducted an unannounced Annual Required Inspection and was met by Licensee, Yong Kwon. The licensee's mother A1 was present and assisting with supervision. Days and hours of operation are Monday through Friday, 7:30am to 6:30pm. The home is set up like a child care center.

LPAs toured the home inside and outside and a census was taken. LPAs observed the licensee operating 15 children upon arrival. Current facility sketch reviewed and confirmed that the downstairs living room and one other room are used for providing care and are accessible to children. There are off-limit areas which were observed not off-limits. There are stairs in the home which lead to the bedrooms. The areas upstairs is off-limits however LPAs observed 6 school aged children working on computers at tables. These children were not supervised upon arrival.

There is no swimming pool or other bodies of water on the premises. There are no firearms or ammunition on the premises. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible. There is a working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort. Safe toys and play equipment are observed. The home has working telephone service and LPA confirmed the phone number is 213-434-8552.

All adults who reside or work in the home have a criminal record clearance or exemption. There are no excluded individuals present at this home. However during the inspection another adult arrived (male). LPA Wheatley asked his name and licensee did not know his name but said he was the after school teacher. Licensee later provided his name and LPA Casillas contacted the RO to verify the prints. Adult 2 is not associated to the facility.
SUPERVISOR'S NAME: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3054
LICENSING EVALUATOR NAME: Veronica WheatleyTELEPHONE: (424) 301-3051
LICENSING EVALUATOR SIGNATURE:

DATE: 07/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2021
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 6
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: KWON FAMILY CHILD CARE
FACILITY NUMBER: 197493415
VISIT DATE: 07/21/2021
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
26
27
28
29
30
31
32
PAGE 2

Licensee did not make sure that children in care are supervised at all times. The outdoor play area in the backyard is fenced and there are no hazards to children present. Capacity as specified on the license is being maintained.

LPAs reviewed a sample of children’s files and observed files were complete with emergency information. However LPAs observed four children on the premises without required records. Licensee’s Mandated Reporter Training was not available. Licensee’s pediatric CPR/First Aid expires on June 2022. A review of records indicates that all employees and/or volunteers have immunization records on file for influenza, pertussis and measles.

LPAs did not observed any infants on the premises. LPAs discussed Safe Sleep Regulations with licensee. Cribs and play yards will be kept free from all loose articles and objects while infants are sleeping, and there are no objects hanging above or attached to the crib or play yard. Infants are not swaddled while in care. Provider will physically check on sleeping infants every fifteen minutes and documents any signs of distress which includes but is not limited to flushed skin color, increase in body temperature, restlessness and labored breathing. Infants can be visually observed through an open door if sleeping in a separate room. Individual Infant Sleeping Plan will be completed and in file for each infant up to 12 months of age. Infants up to 12 months of age are placed on their backs for sleeping.

Incidental Medical Services (IMS) are not currently being provided. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.
SUPERVISOR'S NAME: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3054
LICENSING EVALUATOR NAME: Veronica WheatleyTELEPHONE: (424) 301-3051
LICENSING EVALUATOR SIGNATURE:

DATE: 07/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2021
LIC809 (FAS) - (06/04)
Page: 2 of 6
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: KWON FAMILY CHILD CARE
FACILITY NUMBER: 197493415
VISIT DATE: 07/21/2021
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
26
27
28
29
30
31
32
Page 3

LPAs and Licensee discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following citations are being cited:

102416.5 (a) Staffing Ratio and Capacity
102370(d)(2) Criminal Record Clearance
102417 Operation of a Family Child Care Home
102421(b) Child's records
1596.8662 Availability... training for mandated reporter who is licensed day care provider, administrator, or employee of a licensed child day care facility; proof of completion

This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.

A copy of this report was provided to the licensee today.
SUPERVISOR'S NAME: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3054
LICENSING EVALUATOR NAME: Veronica WheatleyTELEPHONE: (424) 301-3051
LICENSING EVALUATOR SIGNATURE:

DATE: 07/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2021
LIC809 (FAS) - (06/04)
Page: 3 of 6
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: KWON FAMILY CHILD CARE
FACILITY NUMBER: 197493415
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/21/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/22/2021
Section Cited

1
2
3
4
5
6
7
102416.5 (a) Staffing Ratio and Capacity
The capacity specified on the license shall be the maximum number of children for whom care may be provided at any one time.
This requirement is not met as evidenced by:

8
9
10
11
12
13
14
Based on observation, LPAs Wheatley and Casillas observed 15 day care children upon arrival. During the inspection, LPAs observed 6 school-aged children upstairs in an off-limit area, which poses an immediate health, safety or personal rights risk to children in care.
8
9
10
11
12
13
14
Type A
07/21/2021
Section Cited

1
2
3
4
5
6
7
102370(d)(2) Criminal Record Clearance
All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing, or volunteering in a licensed facility: Request a transfer of a criminal record clearance as specified in Section 102370(j)
8
9
10
11
12
13
14
Based on observation LPAs Wheatley and Casillas observed Adult 2 on the premises with a fingerprint clearance that is not associated to licensed facility #197493415, which poses an immediate health, safety or personal rights risk to children in care.
8
9
10
11
12
13
14
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: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3054
LICENSING EVALUATOR NAME: Veronica WheatleyTELEPHONE: (424) 301-3051
LICENSING EVALUATOR SIGNATURE:
DATE: 07/21/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/21/2021
LIC809 (FAS) - (06/04)
Page: 4 of 6
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: KWON FAMILY CHILD CARE
FACILITY NUMBER: 197493415
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/21/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/21/2021
Section Cited

1
2
3
4
5
6
7
102417 Operation of a Family Child Care Home - The licensee shall be present in the home and shall ensure that children in care are supervised at all times.....
This requirement was not met as evidenced by:
8
9
10
11
12
13
14
Based on observation, LPAs Wheatley and Casillas observed 6 school aged children upstairs in an off limit area unsupervised by any adults which poses an immediate health, safety, or personal rights risk to children in care. The licensee is being assessed a civil penalty for lack of supervision.
8
9
10
11
12
13
14

1
2
3
4
5
6
7

1
2
3
4
5
6
7
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: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3054
LICENSING EVALUATOR NAME: Veronica WheatleyTELEPHONE: (424) 301-3051
LICENSING EVALUATOR SIGNATURE:
DATE: 07/21/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/21/2021
LIC809 (FAS) - (06/04)
Page: 5 of 6
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: KWON FAMILY CHILD CARE
FACILITY NUMBER: 197493415
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/21/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/28/2021
Section Cited

1
2
3
4
5
6
7
102421(b) Child's Records- The licensee shall maintain, in each child's record, a copy of the emergency information card as required in Section 102417(g)(7).
This requirement was not met as evidenced by:
8
9
10
11
12
13
14
Based on observation, LPAs Wheatley and Casillas observed 6 school aged children on the premises and licensee stated that she did not have files for 4 out of the 6 children on the premises. This poses a potential risk to the health, safety, or personal rights risk to children in care.
8
9
10
11
12
13
14
Type B
07/28/2021
Section Cited

1
2
3
4
5
6
7
1596.8662 Availability... training for mandated reporter who is licensed day care provider, administrator, or employee of a licensed child day care facility; proof of completion(b) (1) On or before March 30, 2018 ...or employee of a licensed facility...
This requirement was not met as evidenced by:
8
9
10
11
12
13
14
Based on record rewiew, LPAs Wheatley and Casillas did not observe the Mandated Reporter Training completed by the licensee. Licensee appeared to be unaware of the required training which is required every two years.
8
9
10
11
12
13
14
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: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3054
LICENSING EVALUATOR NAME: Veronica WheatleyTELEPHONE: (424) 301-3051
LICENSING EVALUATOR SIGNATURE:
DATE: 07/21/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/21/2021
LIC809 (FAS) - (06/04)
Page: 6 of 6