198003008-8-2-2022-33-CC-SLEE-CGSUER-20220729153133

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198003008
Report Date: 07/29/2022
Date Signed: 08/02/2022 08:24:48 AM

Document Has Been Signed on 08/02/2022 08:24 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	MIN FAMILY CHILD CARE		FACILITY NUMBER:	198003008
ADMINISTRATOR:	MIN, VIVIAN SUNG		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 467-9422
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90004
CAPACITY:	14	CENSUS: 3	DATE:	07/29/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:30 PM
MET WITH:	Vivian Min		TIME COMPLETED:	04:00 PM

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Licensing Program Analyst, Seung Lee conducted an unannounced annual random site inspection to ensure the health & safety standards as required by regulations governing family child care homes. Upon arrival, LPA met with Licensee, Vivian Min and toured the facility. There were 3 children present with the Licensee. Individuals residing in the home are the licensee, licensee's husband, and daughter. Licensee’s operating hours are Monday-Friday 8am-6:30pm.

This is a single story home consisting of 3 bedrooms and 2 bathrooms. The following areas are used for day-care: Living Room, 1 bedroom, 1 restroom, and the front yard. Off limit areas include: 2 bedrooms, 1 bathroom, and kitchen.

Licensee has the Parent’s Rights poster and other appropriate forms posted on wall in the living room. First Aid/CPR certificate are valid thru 10/21/23. Licensee stated she has practiced fire/emergency drills with day-care children on 06/15/2022, providing LPA with disaster drill log. Licensee has a working telephone.

Detergents and cleaning supplies were Inaccessible. Fire extinguisher has been serviced in the last year, card on extinguisher notes 03/01/2022. There is an operational smoke detector and carbon monoxide detector in the kitchen. The home has electrical outlet covers throughout and maintains a First Aid Kit. There are adequate age appropriate toys, books, and games. There are no firearms present on the premises as stated by licensee. There are no pools or spas, or other bodies of water. Currently there is one small dog that resides in the off limits kitchen.

SUPERVISOR'S NAME: Guangorena Claudia	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Seung Lee	TELEPHONE: (323) 981-3382
LICENSING EVALUATOR SIGNATURE:	DATE: 07/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2022

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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: MIN FAMILY CHILD CARE	FACILITY NUMBER: 198003008
	VISIT DATE: 07/29/2022

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LPA Lee reviewed children files on this inspection.

During the inspection LPA Lee advised the Licensee to continue to comply with the guidelines from the CA department of Health for Family Child Care Homes in regards to Health and Sanitation.

The following were discussed: Individuals who are 18 years of age or older living in the home must be finger print cleared prior to being in the presence of the children in care. Individuals within one month of their 18th birthday must be fingerprinted immediately. No smoking, No infant walkers, No baby bouncers, No Johnny jumpers, No exersaucers and any other item that falls into that category. LPA discussed disaster drills, posting requirements, children records requirements, mandated child abuse and injury/death reporting.

A qualified Assistant must be present and actively involved in caring for children whenever nine (9) or more children are present at the facility in a large family child care home.

No Deficiencies were cited on this visit.

Incidental Medical Services are not provided at this time. Licensee was informed to contact the department 30 days prior to enrolling any child with IMS needs.

LPA advised the Licensee Vivian Min to access forms and regulations on line at: www.ccld.ca.gov

Exit interview conducted with Licensee Vivian Min. Appeal rights discussed and explained.

The notice of site inspection must remain posted for a period of 30 days during hours of operation. Failure to maintain posting will result in a civil penalty of $100.00 dollars.

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SUPERVISOR'S NAME: Guangorena Claudia	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Seung Lee	TELEPHONE: (323) 981-3382
LICENSING EVALUATOR SIGNATURE:	DATE: 07/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2022

LIC809 (FAS) - (06/04)

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