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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 03:11:40 PM

Document Has Been Signed on 05/15/2024 03:11 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:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:00 PM
MET WITH:Celeste ChanTIME VISIT/
INSPECTION COMPLETED:
04:00 PM
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On 5/15/24 at 3:00 pm Licensing Program Analyst Claudia Kam conducted a Case Management at the above facility. During inspection LPA was made aware that licensee may be out of the home more that the allotted per licensing requirement. LPA met with licensee Celeste Chan, who guided analysts on a tour of the facility. There were 9 children present with 3 staff upon arrival.

LPA completed record review and interviews were conducted regarding presence of the licensee at the facility. Based on the information gathered it has been deemed that licensee may be out of the facility more than 20% of the allowed time by regulation.



LPA obtained a statement of declaration from the licensee to confirm that she is aware of Title 22 regulation requiring her presence in the facility a min of 80% of the time and a pick up and drop off schedule completed by licensee to ensure that there is the required supervision and presence of licensee at the family child care home.

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

An exit interview was conducted with Celeste Chan
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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