304314281-10-23-2024-06-CC-VTRH-DABU2Y-20241023151242

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304314281
Report Date: 10/23/2024
Date Signed: 10/23/2024 03:12:56 PM

Document Has Been Signed on 10/23/2024 03:12 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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	PARK, MINAM		FACILITY NUMBER:	304314281
ADMINISTRATOR/ DIRECTOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 4	DATE:	10/23/2024
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	12:55 PM
MET WITH:	Park, Minam (Licensee)		TIME VISIT/ INSPECTION COMPLETED:	03:15 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA) Vivian Trinh conducted a case management inspection, in response to licensee’s request for a capacity increase, The Fire clearance granted on 10/2/2024. LPA met with licensee Park, Minam who guided analyst on a tour of the facility. Census was taken, there were 4 infants’ children were napping, with 2 staff members. Licensee stated there are currently three (3) adults living in the home, and two (2) minor children in this facility. Licensee stated she is not currently registered with any Foster Care agency or holds a foster parent license. Licensee was reminded if changes are made to notify the licensing office. Facility Day care hours are 8:00 AM - 5:00 PM, Monday through Friday. A review of the Facility Personnel Report Summary on this date indicates all facility residents, staff, or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemption. All areas on the Facility Sketch LIC999 were inspected, including but not limited to, off-limits areas. The facility is a 1 story house with 4 bedrooms, 2 bathrooms, a living room, a kitchen, a front yard (not fenced), and a backyard with a wall/fence, and garage. There is a fireplace, located in the living room, got cover by the children’s toys-self. There area no stair in this home. Garage will not be used for day-care. The licensee stated the garage will be off limit. The licensee acknowledged the children may never enter the off-limit areas during operation hours. The licensee has a cell phone that is used for childcare. Continued page 2.

SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Vivian Trinh
LICENSING EVALUATOR SIGNATURE:	DATE: 10/23/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2024

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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: PARK, MINAM	FACILITY NUMBER: 304314281
	VISIT DATE: 10/23/2024

NARRATIVE

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The licensee was informed if a cell phone is used for childcare, it must remain on the premises at all times during hours of operation. The licensee was informed and understands the home is to be free from smoking during hours of operation.

Areas Designated for Day Care Activities: The Licensee have designated the living room, and room number 1 on the left-hand side is a nap room for daycare children. children’s bathroom located at right hand side of the hallway, and back yard, some part of the backyard as the day care areas. The front yard has no fence, and the backyard is a day-care area with fence/walls. The Licensee stated that parents and children will enter the front door.

Detergents, cleaning compounds, medicines, and other items which could pose a danger if readily available to children were stored inaccessible to children. Poisons and Hazardous items were not observed. There are no bodies of water, and pets in this facility.

The toys are age appropriate and in good condition for the potential ages served. Baby walkers, bouncers, jumpers, and similar items will not be used for children in care. Licensee stated there are no weapons or firearms on the premises. When firearms are present, they must be locked and stored separately from the ammunition.

During today's inspection, the smoke detector and carbon monoxide were operable, and the fire extinguisher was charged. Fire/disaster drill has been conducted within 6 months. The last fire/disaster was conduct 10/17/2024.

OUTDOOR PLAY AREA: During the pre-licensing inspection the Licensee stated that she will be using one part the backyard as an area of day-care. LPA observed age-appropriate play equipment to be free from hazards. There are no bodies of water, and pets on the premises.

Continued page 3.

SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Vivian Trinh
LICENSING EVALUATOR SIGNATURE:	DATE: 10/23/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2024

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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: PARK, MINAM	FACILITY NUMBER: 304314281
	VISIT DATE: 10/23/2024

NARRATIVE

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The licensee stated she provides morning, lunch and afternoon snacks to day-care children. The licensee was informed that if children bring food from home, the children’s names must be labeled on their lunch bags and refrigerated/stored properly. Licensee stated that the home is free from smoking during hours of operation. Cleaning solutions/chemicals, utensils, and sharp knives located in the kitchen are all inaccessible by child safety latches. Poisons/Hazardous items are not stored on-site, and none were observed.

Per the licensee, children will nap in the room numbers 1 and Living room. Children will nap on cots and infants in cribs/play yards. The licensee understands that there shall be one crib or play yard for each infant who is unable to climb out of the crib or play yard.

The licensee stated that parents will provide linens and parents will provide blankets for napping. The licensee stated that parents will provide diapers, lotion, wipes, and formula for the infants. The blankets will be sent home to be washed weekly and as needed for infants. LPA advised the applicant to always supervise at all times infants when changing their diapers.

Licensee has a current (EMSA approved) Pediatric First Aid and Pediatric CPR certification that expires on 4/2026. A first aid kit is available at the facility located inside the closet near the entrance. The licensee has completed the required mandated reporter training. Recertification is required every two years. Licensee AB1207 mandated reporter certification is current, dated 4/7/26.

The licensee has a current roster of children in care. During this inspection, LPA reviewed four (4) children’s records and they were in compliance. LPA observed LIC 9227 and each of infant safe sleep document.

LPA advised the licensee how to access forms, regulations and quarterly updates online at: www.ccld.ca.gov

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource.
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SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Vivian Trinh
LICENSING EVALUATOR SIGNATURE:	DATE: 10/23/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2024

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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: PARK, MINAM	FACILITY NUMBER: 304314281
	VISIT DATE: 10/23/2024

NARRATIVE

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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, 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 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.

Licensee was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Family Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Fire clearance granted on October 2, 2024

During todays’ inspection, there were no deficiencies cited and licensee was in compliance with California Code of Regulations Title 22 for operating a Family Child Care home.

A new license for operating a Large Family Child Care Home shall be issued upon final approval of management and if additional information is needed, licensee shall be contacted.

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SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Vivian Trinh
LICENSING EVALUATOR SIGNATURE:	DATE: 10/23/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2024

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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: PARK, MINAM	FACILITY NUMBER: 304314281
	VISIT DATE: 10/23/2024

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Exit interview conducted and report was reviewed with the licensee Park Minam. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

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

Appeal Rights were explained. The Licensee was provided a copy of appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days. First level appeals should be sent to the regional manager to the address listed above.

End of Report.

SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Vivian Trinh
LICENSING EVALUATOR SIGNATURE:	DATE: 10/23/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2024

LIC809 (FAS) - (06/04)

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