198019997-10-24-2024-54-CC-JCUT-DACRJ2-20241024130313

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198019997
Report Date: 10/24/2024
Date Signed: 10/24/2024 01:05:31 PM

COMPREHENSIVE INSPECTION

Document Has Been Signed on 10/24/2024 01:05 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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	CHIM FAMILY CHILD CARE		FACILITY NUMBER:	198019997
ADMINISTRATOR/ DIRECTOR:	LESLIE CHIM		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(562) 896-7510
CITY:	LAKEWOOD	STATE: CA	ZIP CODE:	90712
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 8	CENSUS: 7	DATE:	10/24/2024
TYPE OF VISIT:	Case Management - Annual Continuation	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:00 AM
MET WITH:	Licensee, Leslie Chim		TIME VISIT/ INSPECTION COMPLETED:	01:10 PM

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Licensing Program Analyst (LPA) Jonnisha Culbert conducted a continuation of an annual/random inspection previously conducted on October 23, 2024. Due to time constraints LPA expressed to licensee that they will return to complete the annual/random inspection. Deficiencies observed on initial inspection date were not discussed. On October 24, 2024, at 9:05am, LPA met with Licensee, Leslie Chim and expressed the purpose of today’s visit. During today’s visit licensee, assistant 1, 7 children, and 2 adults were present. The following information serves as a report of the information gathered on October 23, 2024.

On October 23, 2024, at 9:15am, Licensing Program Analyst (LPA) Jonnisha Culbert conducted an unannounced annual/random inspection at the facility noted above and met with Licensee, Leslie Chim. LPA disclosed the purpose of today's visit and provided licensee with an entrance checklist for family childcare homes. Licensee guided LPA on a tour of the facility. The operating hours are Monday through Friday 7am to 5:30pm. Individuals residing at the home were discussed and noted. Present during the time of inspection were licensee, assistant 1, 7 children, and 3 adults.

This is a single-family home that consist of 4 bedrooms, 2 bathrooms, dining room, kitchen, living room, front yard, enclosed patio, enclosed backyard, detached garage, and driveway (leading to detached garage).

Currently, on limits areas include 2 bedrooms, dining room (through passing), living room (through passing), 1-bathroom, back patio (through passing), and backyard. Off limits area include 1bathroom, 2 bedrooms, driveway, and detached garage. All areas accessible to children were inspected for safety.

The following documents were not posted in a prominent, publicly accessible area: Facility License, Notification of Parents' Rights (PUB 394), and Emergency Disaster Plan (LIC 610A). Per licensee, the board was removed temporarily when the construction workers painted the wall. LPA advised licensee to keep board information in an area that can be seen by parents. The Licensee had a current Facility Roster (LIC 9040) available for review. Licensee did not have verification of Disaster and Fire Drills available for review.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jonnisha Culbert
LICENSING EVALUATOR SIGNATURE:	DATE: 10/24/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2024

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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: CHIM FAMILY CHILD CARE	FACILITY NUMBER: 198019997
	VISIT DATE: 10/24/2024

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This poses a potential safety risk to children in care.

At approximately 9:17am, LPA observed miter saw, table saw, ladder, 3 buckets filled with construction supplies, two tool bags filled with tools, children’s toys, and a basketball court on the front lawn. LPA observed an extension cord leading from the miter saw into the front door of the home. Per licensee, they received a grant to remodel the home and adult 1, adult 2, and adult 3 have been working on the home for the past 6 weeks. Per licensee, they did not report remodel to the Department. This is a potential health and safety risk to children in care. Due to the remodel, most of the on limits areas of the home is off limits and the off-limits backyard is on limits. This is a potential health and safety risk to children in care.

Per licensee, during the remodel children only utilize the backyard, two bedrooms and bathroom. The backyard is used for eating, playing, and activities and bedrooms are used for napping only. LPA observed three adults working in the areas (dining room, kitchen, and living room) identified on the facility sketch as on limits. Per licensee, the areas previously identified as on limits areas are only used through passing to travel to enter and exit the home, to get to the backyard, bedrooms, and bathroom. Per licensee, children are escorted through these areas to gain access to front door, bathroom, bedrooms, and backyard.

Areas used by children were inspected for safety, comfort, heating, cleanliness, and telephone service. The home does not have any wall heaters. LPA observed a fireplace in the living room that was covered with a board. Per Licensee, the fireplace is not operable. The home is equipped with central air and heating. Detergents, cleaning compounds, and medicines were made inaccessible to children. Per Licensee, poisons are kept in the garage. LPA observed garage door open and advised licensee to close garage door and keep patio door looked because it leads to off limits driveway and garage (where poisons are kept). Licensee was advised that areas where poisons are kept are to remain locked while children are in care. Per Licensee, there are no pets or bodies of water on the premises. LPA observed age-appropriate toys and napping equipment (multiple mats and one crib). Per licensee, only one out of three infants sleep in a crib.

At approximately 9:27am LPA observed infant crib with two mattresses, swaddle, and blanket inside of the it. Furthermore, there was an object hanging above crib. Per licensee, Child 1’s parent left a blanket for child to hold while sleeping and wants child 1 to be swaddled in swaddle pajamas to help them sleep. Licensee was advised that using a mattress that is not specifically made for the crib that it is in poses a potential safety risk to persons in care. LPA informed licensee of safe sleep regulations and advised licensee to remove all items in and hanging above crib. Licensee immediately removed items.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jonnisha Culbert
LICENSING EVALUATOR SIGNATURE:	DATE: 10/24/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2024

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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: CHIM FAMILY CHILD CARE	FACILITY NUMBER: 198019997
	VISIT DATE: 10/24/2024

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At approximately 12:45pm LPA observed children walking through work area (living room) where remodel is taking place barefoot. LPA informed licensee of the dangers that are presented when the children walk through those areas of the home barefoot. Licensee was advised to make sure that children are wearing their shoes when walking through the home to prevent injuries.

LPA observed the required fire extinguisher (2-A:10-B:C) that is fully charged, but it was last serviced on August 24, 2022. Licensee was reminded to have the fire extinguisher serviced yearly. This poses a potential safety risk to persons in care. Smoke detector and carbon monoxide detector were tested and are operable. Per licensee, lunch, PM snack, and dinner are provided to children in care. Licensee was reminded that food that is brought from the child's home shall be labeled with the child’s name and properly stored or refrigerated.

Per licensee, during the remodel food is prepared outside. Items used to prepare and serve food are kept on the patio. Knives are kept inside a cup on the table. LPA advised licensee to make sure that knives and sharp objects are inaccessible to children. Per licensee, knives were moved into a locked box.

LPA conducted a record review of 4 children's records and 2 personnel records. Based on the children's record review, child (C1) did not have a signed Consent for Emergency Medical Treatment (LIC 627), Notification of parent’s rights, Infant sleep plan (LIC 9227), and Personal Rights (LIC 613A). Child 2 requires an updated shot record and child 4 file is missing shot records. Missing forms and shot records pose a potential health and safety risk to persons in care. Based on the personnel record review, assistant 1 did not have proof of immunization against measles, pertussis, flu, or tuberculosis available for review. This is a potential health and safety risk to persons in care.

Based on Licensee's record review, Licensee has proof of immunization against measles, pertussis, and a TB clearance. Licensee has a decline declaration statement available for influenza. Licensee and assistant 1 have a current Pediatric First Aid and CPR certification (expires 07/2026). Licensee completed the Preventative Health and Safety Practices (EMSA-approved) training on March 24, 2018 and Mandated Reporter Training (AB 1207) on 02/17/2023. Assistant 1 completed mandated reporter training on 1/22/2024. Licensee was advised that the Mandated Reporter training (AB 1207) must be completed every 2 years and is available at www.mandatedreporterca.com.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jonnisha Culbert
LICENSING EVALUATOR SIGNATURE:	DATE: 10/24/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2024

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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: CHIM FAMILY CHILD CARE	FACILITY NUMBER: 198019997
	VISIT DATE: 10/24/2024

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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.

Licensee Leslie Chim 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 Leslie Chim 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 Leslie 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 Leslie Chim was informed 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.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jonnisha Culbert
LICENSING EVALUATOR SIGNATURE:	DATE: 10/24/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2024

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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: CHIM FAMILY CHILD CARE	FACILITY NUMBER: 198019997
	VISIT DATE: 10/24/2024

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During the exit interview, Leslie Chim, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

During today’s visit, 9 type B deficiencies were discussed and were previously cited on initial annual/random inspection dated October 23,2024.

A notice of site visit was given and must remain posted for 30 days. Appeal right were given to licensee and TSP services were discussed.

Exit interview conducted and report was reviewed with the licensee Leslie Chim.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jonnisha Culbert
LICENSING EVALUATOR SIGNATURE:	DATE: 10/24/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2024

LIC809 (FAS) - (06/04)

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