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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434416315
Report Date: 03/14/2024
Date Signed: 03/14/2024 01:53:26 PM

Document Has Been Signed on 03/14/2024 01:53 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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:KIM, SOOKKYOUNGFACILITY NUMBER:
434416315
ADMINISTRATOR:KIM, SOOKKYOUNGFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 891-1538
CITY:SAN JOSESTATE: CAZIP CODE:
95117
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 10DATE:
03/14/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:48 PM
MET WITH:Sookkyoung KimTIME COMPLETED:
02:00 PM
NARRATIVE
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Licensing Program Analyst (LPA) Samantha Yip conducted an unannounced Case Management-Other inspection. LPA met with Licensee Sookkyoung Kim and explained the reason for the inspection. The purpose of this inspection is to discuss about Licensee running two family child care home at the same time.

Based on record reviews and interviews, there is a written agreement between Joyful Christian Preschool, Sookkyoung Kim, and the parents of another licensed Family Child Care Home (FCCH). Checks for the other FCCH are made to Licensee and the Licensee's name is on the invoice. LPA discussed with Licensee that she cannot run two FCCH at one time and that she cannot have agreements with parents of another FCCH.

As a result of this inspection, a Type B citation was issued. Exit interview conducted and report was reviewed with Licensee Sookkyoung Kim. A notice of site visit has been issued and must remain posted for 30 days.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Samantha Yip
LICENSING EVALUATOR SIGNATURE: DATE: 03/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/14/2024
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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Document Has Been Signed on 03/14/2024 01:53 PM - It Cannot Be Edited


Created By: Samantha Yip On 03/14/2024 at 01:29 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
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: KIM, SOOKKYOUNG
FACILITY NUMBER: 434416315

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/14/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/21/2024
Section Cited
HSC
1596.78(a)

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“Family day care home." "Family day care home" means a home that regularly provides care, protection, and supervision for 14 or fewer children, in the provider's own home...
This requirement is not met as evidenced by:
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By POC 03/21/2024, Licensee will submit written statement that she understands that she cannot have a contract with parents
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Based on record review and interview, there is a written agreement between Joyful Christian Preschool, Sookkyoung Kim, and the parents of another licensed FCCH. This poses a potential health and safety risk to children in care.
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of another FCCH.

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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:Joel Segura
LICENSING EVALUATOR NAME:Samantha Yip
LICENSING EVALUATOR SIGNATURE:
DATE: 03/14/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/14/2024


LIC809 (FAS) - (06/04)
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