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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198009915
Report Date: 11/14/2024
Date Signed: 11/14/2024 04:23:38 PM

Document Has Been Signed on 11/14/2024 04:23 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:PARK FAMILY CHILD CAREFACILITY NUMBER:
198009915
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 6DATE:
11/14/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Jae Park TIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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Licensing Program Analyst (LPA) Seung Lee conducted an unannounced required inspection. Upon arrival LPA Lee met with Licensee Jae Park who was present with 6 children. The following was observed.

Adults living in the home are the Licensee and Licensee's spouse. Hours of operation are Monday-Friday 8AM-4:30PM. All areas identified on the facility sketch were inspected. This is a two story home which consists of 3 bedrooms, 3 restrooms, kitchen, living room, kitchen, and balcony. 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: All of upstairs which includes 3 bedrooms, and 2 restrooms and kitchen on the first floor. Areas used by children include: Living room, 1 bathroom, and balcony on the first floor. A gate was observed by the stairs leading to the second floor.

During the inspection, LPA observed that CPR for licensee expire on 02/2026. Operational smoke and Carbon monoxide detector were observed in the off limits kitchen on the first floor. Fire extinguisher was last serviced on 07/18/2024 per service tag. LPA observed a drill log for emergency drills conducted. Last drill was conducted on 10/15/2024 per log.

There was no body of water observed. Licensee stated she does not have any pets or own any firearms.

Children's files were reviewed during this inspection by LPA Lee.
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Seung Lee
LICENSING EVALUATOR SIGNATURE: DATE: 11/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/14/2024
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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: PARK FAMILY CHILD CARE
FACILITY NUMBER: 198009915
VISIT DATE: 11/14/2024
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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. Failure to maintain posting for 30 days will result in a civil penalty of $100.00 dollars

Exit interview conducted and report was reviewed with Licensee Jae Park. Appeal rights discussed and explained.

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Seung Lee
LICENSING EVALUATOR SIGNATURE:

DATE: 11/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/14/2024
LIC809 (FAS) - (06/04)
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