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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198009114
Report Date: 08/05/2025
Date Signed: 08/05/2025 03:42:10 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/04/2025 and conducted by Evaluator Jonnisha Culbert
COMPLAINT CONTROL NUMBER: 54-CC-20250804161016
FACILITY NAME:CPC PRESCHOOLFACILITY NUMBER:
198009114
ADMINISTRATOR:KIM SUNG MEEFACILITY TYPE:
850
ADDRESS:11840 E. 178TH ST.TELEPHONE:
(562) 246-0360
CITY:ARTESIASTATE: CAZIP CODE:
90701
CAPACITY:90CENSUS: 56DATE:
08/05/2025
UNANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:Licensee, Kim Sung MeeTIME COMPLETED:
03:50 PM
ALLEGATION(S):
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Facility did not inform parents of Type A citation
INVESTIGATION FINDINGS:
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On 08/05/2025 at 8:40am, Licensing Program Analyst, Jonnisha Culbert conducted an unannounced complaint inspection and met with licensee Sung Mee Kim. It was alleged that licensee failed to inform current and prospective parents of a citation involving an immediate risk to the health and safety of persons in care (Type A citation).

LPA reviewed the facilities record and children’s files. During record review, LPA observed that the licensee was cited for two Type A violations within the past year. During the children’s file review, LPA observed that eight students enrolled between 04/2025 through 07/2025 did not have the required signed Acknowledgement of Receipt of Licensing Report form (LIC 9224) in their files. The licensee was interviewed at 12:30pm and stated that, “[they] did not know they have to give [report and LIC 9224 form] to new parents.” This is an immediate health and safety risk to persons in care. LPA reminded licensee, Kim Sung Mee to provide a copy of all licensing reports that document Type A citations to parents/guardians of all children currently enrolled, and to any newly enrolled parents/guardians for 12 months from the date
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Warren Birks
LICENSING EVALUATOR NAME: Jonnisha Culbert
LICENSING EVALUATOR SIGNATURE:

DATE: 08/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 4
Control Number 54-CC-20250804161016
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: CPC PRESCHOOL
FACILITY NUMBER: 198009114
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/05/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/06/2025
Section Cited
HSC
1596.8595
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(c)(1) A licensed child day care facility shall provide to the parents or guardians of each child receiving services in the facility copies of any licensing report that documents any Type A ...
This requirement is not met as evidenced by:
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Per licensee, they will provide the report to the parents of the eight children and have them review it and sign the LIC 9224 as proof that they have received and read the report. Per licensee, they will email LPA J. Culbert a copy of the signed forms by plan of correcttion date.
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Based on record review and interview, the licensee did not comply with section cited above. LPA J. Culbert observed that eight students did not have a LIC 9224 in their file. When licensee was interviewed they discloed that they did not know they had to give the report to new parents.
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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.
SUPERVISORS NAME: Warren Birks
LICENSING EVALUATOR NAME: Jonnisha Culbert
LICENSING EVALUATOR SIGNATURE:

DATE: 08/05/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 54-CC-20250804161016
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: CPC PRESCHOOL
FACILITY NUMBER: 198009114
VISIT DATE: 08/05/2025
NARRATIVE
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Page 2
of the report. A signed Acknowledgement of Receipt Licensing Report (LIC 9224), or other written statement, must be placed in the child’s file for verification.

Based on the evidence obtained the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated. This requirement is outlined in California Health & safety Code 1596.8595, and it is cited on the attached LIC 9099D.

LPA Jonnisha Culbert informed licensee, Sung Mee Kim that this report dated 08/05/2025 documents one Type A citation which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care. Also, LPA Jonnisha Culbert informed the licensee, Kim Sung Mee to provide a copy of this licensing report dated 08/05/2025 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt Licensing Report (LIC 9224), or other written statement, must be placed in the child’s file for verification.

The Licensee was reminded that the notice of Site Visit must remain posted for 30 days.
Appeal rights were provided, and an exit interview was conducted with licensee, Sung Mee Kim.
SUPERVISORS NAME: Warren Birks
LICENSING EVALUATOR NAME: Jonnisha Culbert
LICENSING EVALUATOR SIGNATURE:

DATE: 08/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 4