198020429-11-18-2021-33-CC-SLEE-C8VT79-20211118132822

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198020429
Report Date: 11/18/2021
Date Signed: 11/18/2021 03:52:15 PM

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:	SHIN FAMILY CHILD CARE		FACILITY NUMBER:	198020429
ADMINISTRATOR:	SANGHEE SHIN & INSEOK SHIN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 733-0642
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90004
CAPACITY:	14	CENSUS: 2	DATE:	11/18/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Sang & Inseok Shin		TIME COMPLETED:	01:30 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	Licensing Program Analyst (LPA) Seung Lee conducted an unannounced required inspection. Upon arrival LPA Lee met with licensees Sang and Inseok Shin who provided a tour of the facility. The following was observed. Adults living in the home are the Licensee and co-Licensee, and 1 adult. Hours of operation are Monday-Friday 8AM-6PM. All areas identified on the facility sketch were inspected. This is a one-story home which consists of 3 bedrooms, 2 full restrooms, kitchen, living room, dining room, laundry room, & den (adjacent to dining room area), backyard (fenced) and front yard (not fenced). The home was inspected for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children. The home has air conditioning throughout the house. Areas off limits include: 2 bedrooms, master bathroom, kitchen, den, laundry room & front yard. Areas used by children include: Living Room, dining room, bedroom adjacent to living room, hallway bathroom, and backyard (fenced). During the inspection, LPA observed that CPR for both licensees expire on 06/2023. Operational smoke and Carbon monoxide detector were throughout the home. Fire extinguisher was last serviced on 09/19/2021. LPA observed a drill log for emergency drills conducted. Last drill was conducted on 11/16/2021 per log. During the inspection LPAs advised the licensee to comply with the latest guidelines from the California department of Health regarding health and sanitation practices for family child care homes.

SUPERVISOR'S NAME: Guangorena Claudia	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Seung Lee	TELEPHONE: (323) 981-3382
LICENSING EVALUATOR SIGNATURE:	DATE: 11/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2021

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: SHIN FAMILY CHILD CARE	FACILITY NUMBER: 198020429
	VISIT DATE: 11/18/2021

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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

LPA advised the applicant how to access forms, regulations and quarterly updates on the Child Care Licensing Website at: www.ccld.ca.gov

There were no deficiencies observed during the inspection.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with Licensees. Sang & Inseok Shin.

SUPERVISOR'S NAME: Guangorena Claudia	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Seung Lee	TELEPHONE: (323) 981-3382
LICENSING EVALUATOR SIGNATURE:	DATE: 11/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2021

LIC809 (FAS) - (06/04)

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