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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198016140
Report Date: 03/25/2025
Date Signed: 03/28/2025 01:47:17 PM

Document Has Been Signed on 03/28/2025 01:47 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:1.2.3. CHRISTIAN MISSIONFACILITY NUMBER:
198016140
ADMINISTRATOR/
DIRECTOR:		JIN KYUNG LEEFACILITY TYPE:
850
ADDRESS:811 S. MANHATTAN PL.TELEPHONE:
(213) 733-1123
CITY:LOS ANGELESSTATE: CAZIP CODE:
90005
CAPACITY: 45TOTAL ENROLLED CHILDREN: 45CENSUS: 40DATE:
03/25/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:45 AM
MET WITH:Jin Kyung LeeTIME VISIT/
INSPECTION COMPLETED:
01:15 PM
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Licensing Program Analyst (LPA) Seung Lee conducted an unannounced Annual/Required Visit. LPA met with designated facility Director, Jin Kyung Lee, who guided LPA on a tour of the facility. All areas identified on the facility sketch were inspected. This is a preschool program licensed for 45 children which operates Monday – Friday from 7:00 AM – 6:00 PM.

Upon arrival, LPA observed 12 children with staff # 1 in the Wale Room, 12 children with staff # 2 in the Dolphin Room, 9 children with staff # 3 in the Penguin Room. 7 Children with Staff #4 in the Nemo Room.

Furniture and equipment was inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. Napping equipment and bedding was inspected for good condition, appropriate storage and cleanliness. Storage for children's belongings was inspected. Age appropriate sinks and toilets were inspected for availability, good repair, water temperature, toilet paper, area safety and sanitation. At this time, the office is used as an isolation area. There are chairs in the office. Parents are contacted immediately when children are determined to be ill.

Snack menus were reviewed. The facility provides Breakfast, lunch and PM snack. All kitchen, food prep, and storage areas are clean, free of litter, rubbish, and rodents/vermin. There is drinking water available in all indoor classrooms and a water dispenser available outdoors. Containers used to discard food have tight fitting lids at this time. Cleaning compounds, detergents and hazardous items are stored in an area inaccessible to children.
NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Seung Lee
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 03/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/25/2025
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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: 1.2.3. CHRISTIAN MISSION
FACILITY NUMBER: 198016140
VISIT DATE: 03/25/2025
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Areas around and/or under climbing equipment, and slides have rubber cushioning material to absorb a fall; climbing apparatuses are single level only. Outdoor play equipment was observed to be in good condition. The Director states that there are no bodies of water on the premises and LPA did not observe any bodies of water during this visit. Smoke and Carbon monoxide detectors were observed. The last disaster/fire drill conducted with children in care was on 03/06/2025 per drill log.

Teacher-child ratios were observed and staff names recorded. Care and supervision was observed to ensure that the basic needs of children are met and appropriate. Sign in and out sheets were reviewed. First Aid supplies are available. Criminal Records Clearance for adults, Qualifications and verification of CPR/First Aid and health preventative practices documentation was reviewed. Director's CPR is valid until 10/2026 per CPR card



Director was informed to contact the department 30 days prior to enrolling any child with IMS needs. LPA advised applicant to refer to Section 101173 and 101226 for further information on regulatory requirements. Regulation Interpretations and Procedures for Child Care Centers Section 102417. 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 licensee to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.

There were no deficiencies cited during today’s inspection

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00. Exit interview was conducted with Jin K. Lee, Director, including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role.
NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Seung Lee
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2025
LIC809 (FAS) - (06/04)
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