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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304313243
Report Date: 12/13/2023
Date Signed: 12/14/2023 08:26:34 AM

Document Has Been Signed on 12/14/2023 08:26 AM - 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:YOO, SU YOULFACILITY NUMBER:
304313243
ADMINISTRATOR:YOO, SU YOULFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(714) 882-9425
CITY:BREASTATE: CAZIP CODE:
92821
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 2DATE:
12/13/2023
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:YOO, SU YOULTIME COMPLETED:
10:30 AM
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A Random inspection was conducted at the facility by Licensing Program Analyst (LPA)
Bootorabi and Jung. Upon arrival, an Entrance Checklist (LIC 126) was provided to the licensee YOO, SU YOUL. The Facility Day care hours were confirmed with the licensee and it was stated that they are 8:15 am am-5:30 pm, Monday through Friday.

Census upon arrival: 0 Day Care Children and 2 Adults

Posted Requirements were reviewed during today’s visit with the licensee. Upon arrival, the LPA verified that the following documents were posted in a prominent, publicly accessible area; License, PUB 394 Notification of Parents Rights, and LIC 9148 Earthquake Preparedness. The licensee had all documents posted in a publicly accessible area.

A facility Tour of the inside and outside area was conducted during today's inspection with the licensee YOO, SU YOUL.

The LPA(s) and licensee toured the facility inside. Areas stated to be off-limits by the facility sketch were made off-limits by baby safety gates in the following areas stair way, and kitchen area.

The licensee stated the children's primary care and play areas consist of the living room area, and family room located in the front part of the home. The home also has 1 bathroom next to the family room that is used by children in care. The home has a backyard that is used by children in care.

The licensee stated children eat on table in the living and family room. The licensee provides meals for the children. The licensee provides am snack, lunch and dinner to children in care.
SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Araceli Bootorabi
LICENSING EVALUATOR SIGNATURE: DATE: 12/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/13/2023
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: YOO, SU YOUL
FACILITY NUMBER: 304313243
VISIT DATE: 12/13/2023
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Detergents, cleaning compounds, medicines, and other items that could pose a danger if readily available to children were not observed to be out or accessible. Floors, equipment, and furniture were clean and were observed to be in good repair and free of sharp edges. The children's bathrooms are clean and sanitary.

Napping: The licensee stated that children nap in the family and living room on mats.
Bedding is stored in the closet next to the bathroom. The licensee send home blankets every week for parents to wash.

The licensee stated there are no firearms and/or other dangerous weapons in the facility and none were observed during today's inspections.

The home has age-appropriate toys for the ages served in the living and family room.

The location & functioning of the carbon monoxide, smoke detector, and fire extinguisher were
reviewed and tested with the license. The fire extinguisher is marked in full. The smoke detector and carbon monoxide were tested and functional.

The cushioning material used at the facility consists of artificial grass in the backyard. The outdoor equipment and toys were in good repair and were free of sharp edges. There are no bodies of water present at the facility. The facility’s outdoor grounds are safe, sanitary, and in good repair. LPA observed one small climbing structure outside for children to play with.
End of indoor & outdoor tour.

The LPA requested to review the LIC 610A Emergency Disaster Plan, Verification of
Disaster and Fire Drills, and LIC 9040 Facility Roster. The last drill was conducted on 04/24/2023 per the disaster and fire drill provided. Licensee conducted a fire drill today 12/13/2023 and understand she must conduct one every six months. The LPA reminded the licensee of the importance of keeping documents up to date. The LPA provided a sample fire drill log and reminded the licensee to conduct it every 6 months. The LPA reviewed the LIC 9040 Facility Roster.

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SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Araceli Bootorabi
LICENSING EVALUATOR SIGNATURE:

DATE: 12/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2023
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: YOO, SU YOUL
FACILITY NUMBER: 304313243
VISIT DATE: 12/13/2023
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The LPA requested to review 3 of 3 records of adults (Staff1-3)working directly with children. The following documents were requested for review CPR First Aid Certification, LIC 9052, Immunization records, TB clearance and LIC 9108, and a Mandated Reporter Training Certificate. S1 had a completed record, S2 was missing Tdap Record but was able to obtain it during today's inspection, and S3 was missing a second portion of the Mandated Reporter Training. A consultation was provided regarding completing the training and obtaining records for vaccines/influenza.

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 exemptions. Currently, there are 4 adults including the licensee and 0
minor child living in the facility. The licensee was reminded that any individuals 18 years or older must have a
background check clearance. The licensee was also reminded that any children turning 18 years must obtain a background check to maintain compliance.

The LPA requested complete children’s records of 3 children enrolled and . Children's records were reviewed, and there was a separate, complete, and current record for each child. The LPA reviewed files to verify the following documents Immunization Records, LIC 700 Identification and Emergency Medical Treatment, and LIC 995A Notification of Parents’ Rights. The children’s records were complete during today's inspection.

A consultation was provided regarding documentation being updated as needed, and providing parent rights cut off portion.
Incidental Medical Services (IMS) policy was discussed and the licensee stated she does not provide IMS currently in her FCCH. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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) Commonly Asked Questions American Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

Know the Law About The Americans with Disabilities Act and Individuals with Disabilities Education Act https://rrnetwork.org/assets/general-files/Child-Care-Law-Center-ADA_IDEA_Housing-April-2019.pdf

SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Araceli Bootorabi
LICENSING EVALUATOR SIGNATURE:

DATE: 12/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2023
LIC809 (FAS) - (06/04)
Page: 3 of 6
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: YOO, SU YOUL
FACILITY NUMBER: 304313243
VISIT DATE: 12/13/2023
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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 Yoo, Su Youl , confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

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

Exit interview conducted and report was reviewed with the licensee Yoo, Su Youl


The facility complied and no violations of the California Code of Regulations, Title 22, Division 12 were observed, discussed, and cited at the time of the visit.

An exit interview was conducted with Yoo, Su Youl . 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 at the address listed above. The Notice of Site Visit was posted and discussed as required by H&S Code Sec. 1596.817. Notice of Site Visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100.00. The Notice of Site Visit must be posted on or adjacent to the door.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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

End of Report
SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Araceli Bootorabi
LICENSING EVALUATOR SIGNATURE:

DATE: 12/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2023
LIC809 (FAS) - (06/04)
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