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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400187
Report Date: 03/02/2021
Date Signed: 03/16/2021 12:54:09 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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:AGAPE SARANG CHILD CENTER-INFANTFACILITY NUMBER:
198400187
ADMINISTRATOR:HYE JOUNGFACILITY TYPE:
830
ADDRESS:1516 S. WESTERN AVETELEPHONE:
(818) 279-1685
CITY:LOS ANGELESSTATE: CAZIP CODE:
90006
CAPACITY:28CENSUS: 3DATE:
03/02/2021
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Hye JoungTIME COMPLETED:
02:30 PM
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A Pre-licensing Tele Inspection was conducted today by Licensing Program Analyst (LPA), Alanna Gontarek to inspect this facility. Due to COVID-19 preventative measures, a tele visit was conducted via Zoom application. LPA met with applicant, Hye Joung who assisted LPA with virtually touring the facility. Census was taken. There were 3 children and 2 staff present during tele visit. LPA observed all staff and children wearing face masks.

This is a proposed Infant Program which consists of 1 classroom: Infant Room. This program will serve children ages, birth to 2 years. This program will operate Monday - Friday 7:30 AM - 6:00 PM. Per Applicant, authorized representatives, of infants in care, will park in the back parking lot and enter through gate. Per Applicant, child's authorized representatives need to call school to receive access into the school. Per Applicant, Infant entry gate is remote controlled for entry into facility. Per Applicant, Preschool children enter through the front of the school, off Cambridge street. Per Applicant, no cameras on-site.

All areas identified on the facility sketch were toured both indoors and outdoors. Measurements will be taken by LPA Seung Lee on a different date to determine license capacity. LPA Seung stated he will schedule a future in-person visit today, 3/2/2021 with applicant to take measurements.

Sign-In and Sign-Out books are located at in front of the Infant room, and a health check will be conducted prior to children signing in on a daily basis.



Indoor: Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. LPA observed children in the Infant Room have their own labeled cubbies to store their belongings.

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SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3391
LICENSING EVALUATOR NAME: Alanna GontarekTELEPHONE: (323) 854-8644
LICENSING EVALUATOR SIGNATURE:

DATE: 03/02/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2021
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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: AGAPE SARANG CHILD CENTER-INFANT
FACILITY NUMBER: 198400187
VISIT DATE: 03/02/2021
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Continuation Page 2

LPA observed age appropriate toys in the Infant room. Linen will be taken home daily to be washed. Napping equipment (8 cribs) and feeding chairs were observed in the Infant Room. Per Applicant, A 4 foot moveable wall or partition will be installed separating the nap area from the indoor activity area. LPA observed the isolation area located in the office. Ill children will use the staff restroom, located in the office. LPA observed a cot available for children to rest, in office, if needed. LPA advised sick children need to be supervised at all times. This room was observed to be conducive for children's use at this time. LPA observed a changing table in arms reach of an operational sink.

Disinfectants, cleaning solutions, and other items that are dangerous to children, are inaccessible to children and stored in latched cabinets beneath changing table. Applicant states there are no poisons on the premises. All kitchen areas/food preparation areas and food storage areas were observed to be clean and are free of litter, rubbish, rodents, and/or any other vermin. Per applicant Kitchen is off-limits to children in care. All storage containers for solid waste, including moveable bins shall have tight-fitting covers that are kept on, and in good repair. Trash cans used to discard food have tight fitting lids. The facility was observed to be free of flies, other insects and rodents. Per applicant, labeled infant bottles will be kept in designated area of the staff refrigerator in staff lounge. Per Applicant, will label drawers in the staff lounge refrigerator, designating specific areas used by staff and/or children.

This program will provide an AM snack and a PM snack. A weekly snack menu is available and posted. Facility will provide breakfast, lunch, and dinner, and will be prepared on-site in Kitchen. LPA observed available drinking water and cups.

LPA observed that facility does not have a carbon monoxide detector. Per applicant, will provide a carbon monoxide detector. LPA observed a smoke detector and a serviced fire extinguisher. The fire extinguisher was serviced 4/25/2021. Applicant states that medication will be stored in the office in a locked box. Per applicant, an Emergency Supply bin and Emergencies backpacks, for each classroom (including each child's emergency information and roster) will be provided.


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SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3391
LICENSING EVALUATOR NAME: Alanna GontarekTELEPHONE: (323) 854-8644
LICENSING EVALUATOR SIGNATURE:

DATE: 03/02/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2021
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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: AGAPE SARANG CHILD CENTER-INFANT
FACILITY NUMBER: 198400187
VISIT DATE: 03/02/2021
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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes 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

Outdoor: Outdoor playground equipment is in a safe condition, free of sharp, loose or pointed parts. LPA advised applicant that the children need to be within the direct care and supervision, including visual supervision of the teachers at all times. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. All areas around or under high climbing equipment, swings, slides, and similar equipment are cushioned with material that absorbs a fall. LPA observed no shade. Per Applicant, will provide a "Zabara"/ tarp. Per Applicant, water pitcher of water and cups are brought outside by the teachers when Infants go outside. The applicant states that there are no bodies of water on the premises and none were observed during this visit. LPA observed a second story, which included one large room. LPA observed a locked gate at the bottom of the steps, making second story inaccessible to children in care. LPA observed a pad locked, latched gated garage, near office. Per applicant, the garage is off limits to children in care. LPA observed an empty building, used as a storage room, next to Infant room. Per Applicant, the empty building is off-limits.


Items discussed during this visit:
***Rooms that are off-limits need to be made inaccessible during operating hours. Smoking is prohibited. No infant walkers, no Johnny Jumpers, no excersaucers or any other item that falls into that category are allowed in facility.

I. Licensing does not tolerate the following: Refused Entry to a Facility or Any Part of a Facility is a violation of Section 1596.852, 1596.853 or 1597.09. Regulations 101238 (g) (2), The Presence of an Excluded Individual, Fire Clearance Violations, Accessible Bodies of Water, Accessible Firearms, Ammunition or Both. Page 3 of 6

SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3391
LICENSING EVALUATOR NAME: Alanna GontarekTELEPHONE: (323) 854-8644
LICENSING EVALUATOR SIGNATURE:

DATE: 03/02/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2021
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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: AGAPE SARANG CHILD CENTER-INFANT
FACILITY NUMBER: 198400187
VISIT DATE: 03/02/2021
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Continuation Page 4

II. Breakfast/Lunch/Snack Menus: Menus are required to be posted one week in advance where it is visible by the child's authorized representative. Menus for the past 30 days must also be available upon request.

III. Current Children’s Roster: Each child day care facility shall maintain a current roster of children who are provided care in the facility. The roster shall include the name, address, and daytime telephone number of the child's parent or guardian, and the name and telephone number of the child's physician. This roster shall be available to the licensing agency upon request.


V. Designated Staff: The name of the child care center director or fully qualified teacher designated to act in the director's absence must be on file. Title 22, Division 12 Chapter 1 Subchapter 02. Infant Care Centers Regulation: 101415.1 Assistant Infant Care Center Director Qualifications and Duties (a) In addition to the director, an assistant director shall be present and on duty if the center has 25 or more infants in attendance.
VI. Qualifications: Educational background, training, and/or experience for each staff present must be available for review. Per applicant, Teacher’s will have a copy of their teacher permit available, and infant units.
VII. Children’s Records: must be available for review; including but not limited to, the following: Name, address and telephone number of the child's authorized representative and of relatives or others who can assume responsibility for the child if the authorized representative cannot be reached when necessary.
VIII. Immunization Requirements: Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles.
IX. LIC 311A - Records to be Maintained at the Facility: Child Care Centers was provided to the applicant during this visit.
X. Mandated Reporter Training (AB1207): The following was discussed: As of January 1, 2018, Health & Safety Code 1596.8662 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. New employees shall have 90 days from date of employment to complete training as required. The training may be met by using the Department’s Office of Child Abuse Prevention (OCAP) online training modules at: http://www.mandatedreporterca.com/.
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SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3391
LICENSING EVALUATOR NAME: Alanna GontarekTELEPHONE: (323) 854-8644
LICENSING EVALUATOR SIGNATURE:

DATE: 03/02/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2021
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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: AGAPE SARANG CHILD CENTER-INFANT
FACILITY NUMBER: 198400187
VISIT DATE: 03/02/2021
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XI. Sudden Infant Death Syndrome (SIDS) and Never-Shake-a-Baby were discussed. LPA also provided a complete packet of the Provider Information Network (PIN) 10-02-CCP dated February 20, 2019 regarding Safe Sleep Awareness Campaign during today’s inspection. LPA provided the following documents about SIDS: A Child Care Provider’s Guide to Safe Sleep from the American Academy of Pediatrics.
XII. Forms, regulations and quarterly updates can be accessed on the Child Care Licensing website at: www.ccld.ca.gov.
**Liability insurance was also discussed. Per Applicant, has liability insurance and will email a copy to LPA.
Prior to Licensing the following items are to be corrected and in compliance with Title 22, California Code of Regulations:
1. Applicant needs to submit Criminal Background Clearance Transfer, LIC 508, and copy of Driver’s License for: Amy Kim.

2. Applicant needs to label drawers in the staff lounge refrigerator, designating specific areas used by staff and/or children.

3. Applicant needs to provide shade in the Infant outdoor playground.

4. Applicant needs to provide carbon monoxide detector

5. Applicant needs to provide an Emergency Supply bin and Emergency backpacks for each room

6. Applicant needs to install a 4-foot moveable wall or partition separating the Infant nap area from the indoor activity area.

7. Applicant needs to provide labeled cubbies for children’s belongings (i.e. lunch boxes, cups, and extra clothing, etc.)
The above items are due on or before 3/12/2021.
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SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3391
LICENSING EVALUATOR NAME: Alanna GontarekTELEPHONE: (323) 854-8644
LICENSING EVALUATOR SIGNATURE:

DATE: 03/02/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2021
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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: AGAPE SARANG CHILD CENTER-INFANT
FACILITY NUMBER: 198400187
VISIT DATE: 03/02/2021
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The applicant is seeking to provide care for 25 Infant children. A fire clearance has been granted. Exit interview conducted with Hye Joung, Applicant.


























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SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3391
LICENSING EVALUATOR NAME: Alanna GontarekTELEPHONE: (323) 854-8644
LICENSING EVALUATOR SIGNATURE:

DATE: 03/02/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2021
LIC809 (FAS) - (06/04)
Page: 6 of 6