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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197414826
Report Date: 07/15/2025
Date Signed: 07/16/2025 07:33:46 AM

Document Has Been Signed on 07/16/2025 07:33 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:PARK FAMILY CHILD CAREFACILITY NUMBER:
197414826
ADMINISTRATOR/
DIRECTOR:		PARK, CHAN G.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 737-3481
CITY:LOS ANGELESSTATE: CAZIP CODE:
90019
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 6DATE:
07/15/2025
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:30 PM
MET WITH:Licensee, Chan ParkTIME VISIT/
INSPECTION COMPLETED:
03:35 PM
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On 07/15/2025 Licensing Program Analyst (LPA) Brittany Lovest conducted an unannounced 3 Year Required Inspection at the above-mentioned facility. LPA was greeted by Licensee, Chan Park. Assistant (S2)assisted with translation in Korean during today’s visit. LPA Lovest disclosed the purpose of the inspection and were granted entry into the home. LPA toured the home both inside and outside. Present during today’s inspection was Licensee, Licensees spouse, and two fingerprint cleared adults. LPA observed Licensee and one assistant providing care and supervision for 6 children.

Capacity as specified on the license is being maintained during today’s inspection.

The purpose of this inspection is to ensure that health, safety, and personal rights as required by Title 22 Regulations governing California Child Care Homes will be met by the licensee. The facility is licensed for Large Child Care Home with a max capacity of 14 children. Currently the facility is available to take children ages 2 months old to 4 years old. Operating hours are Monday – Friday 7:30am -5:30pm. Licensee provides meals and snacks. Per Licensee the Licensee and Licensee Spouse reside in home.

LPA Lovest toured the home inside and outside for a Health and Safety inspection. The single-family home consists of the following: 3 bedrooms, 3 bathrooms, living room, family room, dining room, enclosed patio, kitchen, detached garage and fenced back yard.
The ON LIMIT areas are as follows: living room (day care room), dining room (day care eating area), enclosed patio (day care paly area), family room (class/nap room), bedroom #1 (infant room) and the fenced backyard.
The OFF LIMIT areas are: bedrooms #2, and #3, bathroom #2 and #3, and the kitchen, all of which are made inaccessible by locked doors, child safety door handles, and supervision.
NAME OF LICENSING PROGRAM MANAGER: Loyce Phillips
NAME OF LICENSING PROGRAM ANALYST: Brittany Lovest
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 07/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/15/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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Document Has Been Signed on 07/16/2025 07:33 AM - It Cannot Be Edited


Created By: Brittany Lovest On 07/15/2025 at 01:52 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: PARK FAMILY CHILD CARE
FACILITY NUMBER: 197414826

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/15/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(b)(3)
Infant Safe Sleep
(b) Cribs or play yards shall be free from all loose articles and objects. (3) There shall be no objects hanging above or attached to the side of the crib.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in 2 out of 3 cribs had mobiles attached to the side of the crib which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/16/2025
Plan of Correction
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Licensee agrees to no longer use mobiles or other loose articles attached or in crib. Licensee corrected deficieny during todays visit.
Type B
Section Cited
HSC
1597.622(c)
Administration of Child Day Care Licensing
(c) The family day care home shall maintain documentation of the required immunizations or exemptions from immunization, as set forth in this section, in the person's personnel record that is maintained by the family day care home.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on iinterview, and record review, the licensee did not comply with the section cited above in 1 out of2 Staff files reviewed were missing documentation of immuization records which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 08/05/2025
Plan of Correction
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Licensee will send LPA S2 immunization records to LPA via email by the POC due date.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Loyce Phillips
NAME OF LICENSING PROGRAM MANAGER:
Brittany Lovest
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 07/15/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/15/2025


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 07/16/2025 07:33 AM - It Cannot Be Edited


Created By: Brittany Lovest On 07/15/2025 at 01:52 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: PARK FAMILY CHILD CARE
FACILITY NUMBER: 197414826

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/15/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(j)(2)(D)
Infant Safe Sleep
Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, record review, the licensee did not comply with the section cited above in 3 out of 3 infant files were missing documentation of sleep logs, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 08/05/2025
Plan of Correction
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Licensee will send LPA Sleep logs for children in care for 5 days to LPA via email by the POC due date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Loyce Phillips
NAME OF LICENSING PROGRAM MANAGER:
Brittany Lovest
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 07/15/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/15/2025


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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: PARK FAMILY CHILD CARE
FACILITY NUMBER: 197414826
VISIT DATE: 07/15/2025
NARRATIVE
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There are no firearms and ammunition on the premises. No bodies of water were observed on the premises. Hazardous materials are kept out of the reach of children: Detergents and cleaning compounds are kept in the cabinet in locked kitchen, making all contents inaccessible to the children in care.

Licensee confirmed that the home is not available to take in a child that might need Incidental Medical Services (IMS). Currently there are no children that require IMS in the home.

LPA observed smoke and carbon monoxide detectors throughout the home. There is a full charged 2A:10:BC fire extinguisher in the living room. LPA observed parent board located at the entrance of the home with required postings.

Adequate heating and ventilation for safety and comfort were observed in the space. There are no stairs in the home. Safe toys and play equipment are observed. The home has a working telephone service.

LPA reminded Licensee the importance of ensuring that children in care are supervised at all times and is aware children should not be left in parked vehicles. Car seats are used for transportation purposes only and are not used for sleeping children

LPA reviewed Fire and Earthquake drill log has not been conducted in the past 6 months . LPA advised Licensee Drills are required to be conducted every six months and required be documentation of drill available for the departments review.

LPA reviewed 5 children files to be complete and current with required documentation for a Family Child Care Home. LPA reviewed Licensee and (S2) assistant files. LPA observed Assistant (S2) is missing Immunization records for the departments review, which is a potential risk to children in care, Type B violation cited. See LIC 809D. LPA reminded Licensee staff are required to have a current Mandated Reporter training on file one and at least one person must be present with a valid CPR First Aid certificate for the department’s review.

At 12:41 PM LPA Lovest examined infant sleeping room. LPA observed three cribs with three infants in cribs with hanging mobile attached to the side of two cribs along with a loose sheet in one crib which is a potential risk to children in care, Type B violation cited. See LIC 809D. Licensee removed both mobiles and replaced sheet with a fitted sheet. At 1:30PM LPA Lovest observed three sleeping infants and requested sleep logs for review. Licensee did not have logs available for review, which is a potential risk to children in care, Type B violation cited. See LIC 809D. LPA Lovest reviewed Safe Sleep and sleeping logs requirements for a Family child care home with licensee.
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NAME OF LICENSING PROGRAM MANAGER: Loyce Phillips
NAME OF LICENSING PROGRAM ANALYST: Brittany Lovest
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2025
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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: PARK FAMILY CHILD CARE
FACILITY NUMBER: 197414826
VISIT DATE: 07/15/2025
NARRATIVE
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Family Child Care Home Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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: https://www.ada.gov/resources/child-care-centers/.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, Three Type B Deficiencies were cited.

An exit interview was conducted with Licensee. A copy of this report was discussed and left with Licensee. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

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NAME OF LICENSING PROGRAM MANAGER: Loyce Phillips
NAME OF LICENSING PROGRAM ANALYST: Brittany Lovest
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2025
LIC809 (FAS) - (06/04)
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