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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197495579
Report Date: 04/17/2025
Date Signed: 04/18/2025 10:43:48 AM

Document Has Been Signed on 04/18/2025 10:43 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 RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:KIM FAMILY CHILD CAREFACILITY NUMBER:
197495579
ADMINISTRATOR/
DIRECTOR:		JOYCE KIMFACILITY TYPE:
810
ADDRESS:TELEPHONE:
2132494450
CITY:LOS ANGELESSTATE: CAZIP CODE:
90019
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
04/17/2025
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:29 AM
MET WITH:Licensee-Joyce KimTIME VISIT/
INSPECTION COMPLETED:
11:45 AM
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On 04/17/2025 Licensing Program Analyst (LPA) Brittany Lovest conducted an ANNOUNCED PRE-LICENSING INSPECTION with applicant Joyce Kim. Joyce Kim submitted an application for relocation on 2/24/2025. Present during today’s visit was applicant and applicants’ minor child. Hours of operation are Monday – Friday, 8:00am – 6:00pm. Applicant will provide meals, snacks, and water.

The home was toured with the applicant for a health and safety inspection.

The current facility sketch was reviewed, and LPA Lovest confirmed that home consists of the following: living room 1, living room 2, dining room, kitchen, laundry room, 3 bedrooms, 2 bathrooms, detached garage at rear of home and fenced backyard.

The Applicant has requested the following rooms be ON-LIMITS: living room 1(infant Daycare area), living Room 2(Daycare room1), dining room (Daycare room2), bathroom #1, and gated backyard. The ISOLATION AREA will be in living room 1.

The applicant has requested the OFF-LIMIT AREAS are as follows: Bedroom #1, Bedroom #2, Bathroom #2, Bedroom #3, Laundry room, Kitchen, and Detached garage. Bedroom#1, Bedroom#2, Bedroom#3 Bathroom#2 and laundry room are made in accessible by locked/closed doors and visual supervision. Kitchen is made inaccessible by a safety latch on door leading to the dining room. Kitchen access through hallway is made inaccessible by a safety gate.

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NAME OF LICENSING PROGRAM MANAGER: Claudia Escobedo
NAME OF LICENSING PROGRAM ANALYST: Brittany Lovest
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/17/2025
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: KIM FAMILY CHILD CARE
FACILITY NUMBER: 197495579
VISIT DATE: 04/17/2025
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LPA Lovest observed parent board at the entrance of the home.

The home is neat and clean with heating and ventilation for safety and comfort. The FCCH has a working phone and LPA Lovest confirmed number with applicant matches the departments records.

LPA Lovest observed age-appropriate toys, books and furnishing and equipment that are in good condition, free of sharp, lose or pointed parts.

Applicant is applying for a Large Family Child Care License with a max capacity of 14. Applicant provided proof of control of property. Fire clearance was granted on 3/25/2025 by Inspector Lawrence Kim. Pull fire alarm system, carbon monoxide detector, First Aid kit and 3A:40:BC fire extinguisher was observed in Daycare room 2.

The bathroom that children will use is in the hallway next to daycare room 2. LPA observed the tub, shower, toilet and sink area. The medicine cabinet storage, under the sink and bathroom storage was observed with a safety latch making the toiletries inaccessible to the children in care.

Any poisons, detergents/cleaning compounds, medication and hazardous items that can pose a danger to children are made inaccessible to children in care by being housed in locked off limit’s areas. Cleaning compounds and knives are stored in locked cabinets in off limits kitchen.

Children will access the backyard through main door entrance and walk on side of home to gate on side of home. The outdoor area was observed and inspected. The back yard was observed to have a play area with artificial turf. The back yard was observed with a variety outdoor equipment. The area is enclosed with a gate surround the perimeter of the yard. A detached garage was observed in the space. Appllicant confirmed garage is OFF LIMITS to the children in care yard. The detached garage was made inaccessible by a lock on the gate.

There are no pools, ponds, spas or other bodies of water on the property.

The Applicant and assistant has current CPR/First Aid certificates and Mandated Reporter Training certificates and is in compliance with the immunization law which pertains to day care providers. LPA Lovest reminded applicant that the CPR/First Aid and Mandated Reporter training are to be updated every 2 years.

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NAME OF LICENSING PROGRAM MANAGER: Claudia Escobedo
NAME OF LICENSING PROGRAM ANALYST: Brittany Lovest
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2025
LIC809 (FAS) - (06/04)
Page: 3 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: KIM FAMILY CHILD CARE
FACILITY NUMBER: 197495579
VISIT DATE: 04/17/2025
NARRATIVE
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There are no guns or ammunition stored on the premises.

LPA discussed the safe sleep regulations with applicant and discussed the Child Care Licensing Safe Sleep webpage https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and­resources/safesleep as an additional resource. LPA Lovest informed applicant of the importance of checking for recalled infant devices on the United States Consumer Products 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 the purchased equipment.

California Law requires Family Child Care Home applicants to report unusual incidents or injuries to children in care to child's parents and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624). Incidents must be reported within 24 hours by phone, fax, or electronic mail. Roster of the children must be properly maintained, and fire/disaster drill every six months must be documented. Please report Telephone number changes and/or if you move from home.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

LPA provided applicant with the LIC 311D, Forms/Records to Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted.

In addition, LPA Lovest informed applicant of the following:

o There is an effective 24/7 ban on smoking tobacco in a home that is licensed as a family day care home, and in those areas of the family day care home where children are present.

o Children and Staff records must be maintained and updated as needed and must be available for review by the Department.

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NAME OF LICENSING PROGRAM MANAGER: Claudia Escobedo
NAME OF LICENSING PROGRAM ANALYST: Brittany Lovest
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2025
LIC809 (FAS) - (06/04)
Page: 4 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: KIM FAMILY CHILD CARE
FACILITY NUMBER: 197495579
VISIT DATE: 04/17/2025
NARRATIVE
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o Saucer chairs, bouncers, walkers, or any similar items are prohibited.

o All adults living and working in the home shall be made of aware of the Departments right to inspection authority, which includes but not limited to the right to enter the home when children are being cared for, interview children and adults and review documentation.

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

The applicant is reminded any structural changes to the home or additions to the childcare facility must be reported to Community Care Licensing. Applicant was reminded of Departments inspection authority, with or without any notice.

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

Applicant 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.

Prior to licensing, applicant will make the following corrections, on or before 4/24/2025:

·Make AC Vent in outdoor play area inaccessible to children.

An exit interview was conducted, and report was reviewed and provided to applicant Joyce Kim. The licensing relocation determination of this application will be reviewed with Licensing Program Manager for final resolution.

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NAME OF LICENSING PROGRAM MANAGER: Claudia Escobedo
NAME OF LICENSING PROGRAM ANALYST: Brittany Lovest
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2025
LIC809 (FAS) - (06/04)
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