<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020464
Report Date: 04/16/2024
Date Signed: 04/16/2024 02:57:08 PM

Document Has Been Signed on 04/16/2024 02:57 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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:MIH FAMILY CHILD CAREFACILITY NUMBER:
198020464
ADMINISTRATOR/
DIRECTOR:		CELINE MIHFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 228-0263
CITY:SOUTH PASADENASTATE: CAZIP CODE:
91030
CAPACITY: 14TOTAL ENROLLED CHILDREN: 16CENSUS: 14DATE:
04/16/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:45 PM
MET WITH:Celine MihTIME 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
On 04/16/2024 at am 12:45 pm Licensing Program Analysts (LPAs) Shushanik Safaryan and Saul Valenzuela conducted an unannounced required 3-year inspection to the above facility. A COVID risk assessment was conducted upon entry. LPAs met with Licensee, Celine Mih ,to whom the reason for the visit was explained. Per Licensee, there are 16 children currently enrolled. There were 14 children, and 3 licensees’ assistants and licensee present upon arrival. LPAs observed 5 children with 1 staff member playing outside and 9 napping children with 2 staff members in the family room including 1 infant in play pin. The licensee was observed to be operating within the license capacity limitations.

The licensee states that 2 adults and 3 children currently live in the home. All adults living in the home have obtained a criminal record clearance.

This is a two -story home which consists of 4 bedrooms, 3 bathrooms, living room, dining room, kitchen, , family room ,garage and backyard which is fenced.

Care is provided in the family room , bedroom ,bathroom in the hallway located in the family room and backyard .Per licensee parents enter through the back entrance to the outdoor area , then through sliding doors to the family room .

Per licensee, areas off limits to children and parents includes entire second floor , kitchen , dinning area , garage . LPAs observed child safety gate in the hallway making off limit areas inaccessible to the children .

During this visit, all areas identified that are accessible for children to use were inspected for the safety, comfort, and cleanliness.

Page 1 of 4
SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE: DATE: 04/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/16/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: MIH FAMILY CHILD CARE
FACILITY NUMBER: 198020464
VISIT DATE: 04/16/2024
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
26
27
28
29
30
31
32
 At 1:00 pm Licensee guided LPA to the tour of the home. LPA was toured starting from the living room, where LPAs observed napping children with staff members, children’s toys , chairs . Next LPA toured the bedroom , which is used for activities , where LPAs observed toys , art supplies . LPA toured the bathroom used by children and did not observe any hazards . Next LPAs toured outdoor play area . Currently, children are using the backyard for outdoor play time. The outdoor play area was observed to be fenced and gated. LPA observed that the outdoor yard has toys and other materials for children to play with. LPA did not observe any objects that can pose danger to children. No bodies of water were observed on this day.

Facility License, Emergency Disaster Plan, Parent’s Rights Poster, and Earthquake Preparedness Checklist were observed to be posted in the family room next to the sliding doors . A current children’s roster was available for review.

There is telephone service via a cellphone that stays at the facility during operation hours. Hours of operation are Monday – Friday, 8:00 am – 5:00 pm. There is central air and heating in the home.

Detergents, cleaning compounds, and medications were observed to be inaccessible to children. Per Licensee, there are no poisons in the home. LPA advised that any poisons should be locked under key or combination lock. Licensee states that there are no firearms or weapons stored in the home.
At 1:30 pm LPAs observe 2A 10BC fire extinguisher , but licensee was not able to provide receipt or service tag . Licensee indicated she will purchase new one and will send the proof of the purchase to the LPA. LPAs observed smoke and carbon monoxide but were not able to test since children were napping .

All homes shall conduct fire and disaster drills at least once every six months and document the date and time of each drill. Last drill documented was conducted on 03/01/24.

The home is observed to be clean and orderly. There are first aid supplies available. There are age-appropriate toys available for children.
Per licensee, she provides food for children in care. Licensee was advised that if food is brought from the children’s homes, all containers must be labeled with child’s name and properly stored or refrigerated.

Page 2 of 4
SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE:

DATE: 04/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/16/2024
LIC809 (FAS) - (06/04)
Page: 4 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: MIH FAMILY CHILD CARE
FACILITY NUMBER: 198020464
VISIT DATE: 04/16/2024
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
26
27
28
29
30
31
32
At 02:00 pm Licensee and staff records were reviewed. The licensee has completed training on preventive health practices including Pediatric First Aid and CPR. The licensee's Pediatric First Aid and CPR expires on 10/29/2025.
LPAs observed that the Licensee and assistant Mandated Reporter AB 1207 compliant Child Care Training Certificate on file expired , which poses potential risk to health and safety to children in care .LPAs reminded licensee to renew every 2 years .www.mandatedreporterca.com
Children’s records were reviewed, including emergency information and were observed to be complete. Licensee states she is currently caring for only for 1 infant over 12 months .Per licensee assistant always present while children napping . LPAs reviewed Safe Sleep regulations with licensee and advised to record 15 minute checks .
LPA created an LIC 857, Children’s Record Review, and LIC 859, Staff Record Review which documents staff and children’s files reviewed during this inspection.
Per licensee, there are no animals on the premises.
Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.
LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs, and/or any other item that fall into these categories are not permitted in a family childcare facility.

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 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. Page 3 of 4

SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE:

DATE: 04/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/16/2024
LIC809 (FAS) - (06/04)
Page: 6 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: MIH FAMILY CHILD CARE
FACILITY NUMBER: 198020464
VISIT DATE: 04/16/2024
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
26
27
28
29
30
31
32
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.

LPA advised the licensee how to access forms, regulations and quarterly updates on the Child Care Licensing website at www.ccld.ca.gov.

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

During the exit interview, the LICENSEE Celine Mih , confirmed that there are no Registered Sex Offenders living in the facility .

Based on the LPA’s observations and records review, the following deficiencies listed on the attached LIC 809D (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.



Exit interview was conducted and report , appeal rights were reviewed with the licensee Celine Mih.

Page 4 of 4

SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE:

DATE: 04/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/16/2024
LIC809 (FAS) - (06/04)
Page: 5 of 6
Document Has Been Signed on 04/16/2024 02:57 PM - It Cannot Be Edited


Created By: Shushanik Safaryan On 04/16/2024 at 02:34 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: MIH FAMILY CHILD CARE
FACILITY NUMBER: 198020464

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/16/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(1)
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: (1) Fireplaces and open face heaters shall be screened to prevent access by children. The home shall contain a fire extinguisher and smoke detector device which meet standards established by the State Fire Marshall.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observations , interview and record review the licensee did not comply with the section cited above. LPAs observed Fire extinguisher in the box without servise tag or purchase recipt. Licensee was not able to provide proof of purchase or servise tag for fire extinguisher , which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/30/2024
Plan of Correction
1
2
3
4
Licensee will purchase new fire extinguisher and send the proff to the LPA by POC date .
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observations , interview and file review , the licensee did not comply with the section cited above . Licensee and assistant had a expired Mandated Reporter Certificate ,which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/30/2024
Plan of Correction
1
2
3
4
Licensee will email copy of the certificates to the LPA by POC date .
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:Claudia Guangorena
LICENSING EVALUATOR NAME:Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE:
DATE: 04/16/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/16/2024


LIC809 (FAS) - (06/04)
Page: 2 of 6