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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019997
Report Date: 12/11/2024
Date Signed: 12/11/2024 04:04:21 PM

Document Has Been Signed on 12/11/2024 04:04 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 CAREFACILITY NUMBER:
198019997
ADMINISTRATOR/
DIRECTOR:		LESLIE CHIMFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 896-7510
CITY:LAKEWOODSTATE: CAZIP CODE:
90712
CAPACITY: 14TOTAL ENROLLED CHILDREN: 8CENSUS: 4DATE:
12/11/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:20 PM
MET WITH:Licensee, Leslie ChimTIME VISIT/
INSPECTION COMPLETED:
04:20 PM
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On 12/11/2024 at 2:20pm, Licensing Program Analyst (LPA) Jonnisha Culbert conducted an unannounced Plan Of Correction (POC) visit at the above-mentioned facility. LPA met with licensee, Leslie Chim and stated the purpose of today’s visit. Licensee guided analyst on a tour of the facility. The purpose of today’s inspection is to ensure that all deficiencies addressed on 10/23/2024 are corrected. During today’s visit 4 children, adult 1, assistant 1, and licensee were present.

LPA observed that the following deficiencies were corrected:

-Areas in the home utilized by children are neat and orderly

-Fire extinguisher was serviced

-Sleep logs were completed for infants.

During today’s inspection, LPA observed that all areas of the, on limits to children, were well maintained and organized, the fire extinguisher was serviced on 11/11/2024, and licensee showed proof that sleep logs were completed for the three infants in care from October 2024 to December 2024.

No deficiencies were cited during today’s visit.

A notice of site visit was given and must remain posted for 30 days.

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

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Jonnisha Culbert
LICENSING EVALUATOR SIGNATURE: DATE: 12/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/11/2024
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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