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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400479
Report Date: 05/15/2024
Date Signed: 05/15/2024 04:12:54 PM

Document Has Been Signed on 05/15/2024 04:12 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:CHAN FAMILY CHILD CAREFACILITY NUMBER:
198400479
ADMINISTRATOR/
DIRECTOR:		CELEST CHANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 610-2584
CITY:LYNWOODSTATE: CAZIP CODE:
90262
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
05/15/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:00 PM
MET WITH:Celeste ChanTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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On 5/14/24 at 12:00 PM Licensing Program Analysts (LPA) Claudia Kam conducted an Unannounced Required 1 year Annual inspection to the above facility. LPA disclosed the purpose of the inspection and met with Licensee, Celeste Chan who guided the LPA on a tour of the facility. Entrance Checklist was provided to the licensee.

There are 2 adult living in the home. All adults in the home were found to have criminal record clearance. Documentation for spouse has been discussed. There were 9 day care children present during today’s inspection. Licensee states that there are currently 14 children enrolled. The children's roster was reviewed and is current. Licensee reports that the facility’s hours of operation are 7:40 AM to 5:00 PM, Monday thru Friday. Emergency Disaster Plan, License, and Parents’ Rights were posted at the time of inspection. Per Licensee, disaster drill was last conducted on 2/24/2024 and drill log was observed.

This is a single-story home which consists of three bedrooms and two bathroom, kitchen, living room, and front yard and step down living room and bonus room. Areas used by the children include the step down living room, bonus room, and step down living room bathroom. When children are sick isolation area will be outside or inside depending on the location of the other children and parents are called immediately to pick up within one hour. Per Licensee, areas off limits to children and parents include kitchen, 2 bedrooms, upstairs living room and upstairs bathroom, and laundry room. LPA observed that there is a baby gate and barn door making it inaccessible to children in care at time of inspection. Per licensee, off limit bedrooms kept inaccessible with hallway door closed. Laundry room is kept inaccessible by a baby gate and locked back door.

All areas identified on the facility sketch as accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for the safety of the children. Main Care Area for day care has been observed to have fans and central air conditioning. There is a working telephone maintained in the home via cell phone that is kept in the home at all times.
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SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Claudia Kam
LICENSING EVALUATOR SIGNATURE: DATE: 05/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/15/2024
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: CHAN FAMILY CHILD CARE
FACILITY NUMBER: 198400479
VISIT DATE: 05/15/2024
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LPA has reviewed file for adults living in the home and documentation noted and discussed. Per licensee, the children will have access to the backyard for outside play. LPA observed 2 play structures for older children and one infant play structure and infant slide, 2 play houses, tetter totter and play tables. Covered patio has multiple tables and toys for outside activities. LPA observed yard has grass and adequate perimeter fencing through-out the property with a baby gate on the side of the house to make it inaccessible to children to prevent access to side gate. Right side gate used for entrance to the facility is made in accessible via a locked gate and baby gate. LPA observed the outdoor play area to be free of loose and sharp parts available for the children and the yard to be maintained.

The valve on the required 2A 10BC fire extinguisher indicates fully charged, proof of purchase reflects date of 04/25/24. LPA checked smoke and carbon monoxide detectors at time of visit and were found to be operable. LPA observed First Aid kit in child care area bathroom. Licensee provided proof of immunization against influenza, pertussis, and measles during today’s inspection. Licensee has current mandated reporter training with an expiration date of 06/22/2023.
—CPR Card valid until: 07/12/2025
—Children records and required licensing forms were reviewed and are in compliance at time of visit.

Per Licensee, there are no weapons, firearms in the home and there are no bodies of water around the premises. LPA did not observe any bodies of water around the premises at time of inspection. Per licensee, they provide food for children in care however some children do bring their own food which is stored in the outside refrigerator. Proper storage of food brought by parents discussed. Food preparation area was toured and found in compliance for safety, cleanliness, and proper storage.

The following were discussed:


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.

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SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Claudia Kam
LICENSING EVALUATOR SIGNATURE:

DATE: 05/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2024
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: CHAN FAMILY CHILD CARE
FACILITY NUMBER: 198400479
VISIT DATE: 05/15/2024
NARRATIVE
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Criminal Record Clearance. Licensee Celeste Chan 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 and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee 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, an updated Plan of Operation that includes 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California



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

Based on this information the following deficiencies on the LIC 809 D are being cited today 05/15/2024.

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

Exit interview conducted and report was reviewed with the licensee Celeste Chan.
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SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Claudia Kam
LICENSING EVALUATOR SIGNATURE:

DATE: 05/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 05/15/2024 04:12 PM - It Cannot Be Edited


Created By: Claudia Kam On 05/15/2024 at 02:10 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: CHAN FAMILY CHILD CARE
FACILITY NUMBER: 198400479

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/15/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(f)
Operation of A Family Child Care Home
(f) If food is brought from the children's homes, the container shall be labeled with the child's name and properly stored or refrigerated.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and licensee interview, the licensee did not comply with the section cited above regarding food items that are not labeled with the childs name which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/15/2024
Plan of Correction
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Licensee has labeled the container at time of visit and POC has been corrected on 5/15/24
Type B
Section Cited
CCR
102417(g)(4)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and licensee discussion, the licensee did not comply with the section cited above. LPA observed cleaning supplies in the childcare area bathroom above the toilet at time of inspection and in storage cabinets in nap area were accessible to children which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/15/2024
Plan of Correction
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Licensee has locked the storage cabinet and bathroom cabinet at time of visit and POC has been corrected on 5/15/24.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Denise Gibbs
LICENSING EVALUATOR NAME:Claudia Kam
LICENSING EVALUATOR SIGNATURE:
DATE: 05/15/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/15/2024


LIC809 (FAS) - (06/04)
Page: 4 of 5
Document Has Been Signed on 05/15/2024 04:12 PM - It Cannot Be Edited


Created By: Claudia Kam On 05/15/2024 at 02:37 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: CHAN FAMILY CHILD CARE
FACILITY NUMBER: 198400479

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/15/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(b)(3)

(b) Cribs or play yards shall be free from all loose articles and objects. (3) There shall be no objects hanging above or attached to the side of the crib.


This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above play yards have a attached overhead canopy and blankets in the the play yards at time of visit which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/24/2024
Plan of Correction
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Licensee states that she will remove the attached canopy to the play yards and submit photo verification by the POC due date of 5/24/24. Licensee removed blankets in play yard at time of visit.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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.
SUPERVISOR'S NAME:Denise Gibbs
LICENSING EVALUATOR NAME:Claudia Kam
LICENSING EVALUATOR SIGNATURE:
DATE: 05/15/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/15/2024


LIC809 (FAS) - (06/04)
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