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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198006582
Report Date: 05/06/2021
Date Signed: 05/06/2021 03:40:31 PM

Document Has Been Signed on 05/06/2021 03:40 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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:BENAVIDES FAMILY CHILD CAREFACILITY NUMBER:
198006582
ADMINISTRATOR:BENAVIDES, ANGELICAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 914-6115
CITY:GLENDORASTATE: CAZIP CODE:
91740
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 14DATE:
05/06/2021
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Angelica Benavides TIME COMPLETED:
04:00 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) Judy Mora contacted the facility via telephone. LPA Mora identified herself and spoke to Licensee Angelica Benavides. LPA discussed the purpose of the call. The call was then transferred to Facetime. Licensee's husband, John Benavides and Licensee's mother, Maria Cuevas were also present during the inspection. LPA visually observed 14 children present at 3:20 PM.

LPA Mora found that during interviews conducted with children, disclosures were made in regards to a Personal Rights violation conducted by the Licensee and/or the licensee's husband. Disclosures indicated that children are made to stand in the corner when they are in trouble. More than 1 child disclosed this information. This is an immediate risk to the health and safety of children in care. Title 22 Regulation Section 102423 Personal Rights states (a) Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. These rights include, but are not limited to, the following: (4)To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature.

Upon receipt of this report, the licensee shall post ANY licensing report documenting a type “A” citation. This must remain posted for 30 days during hours of operation. In addition to posting this report, the licensee will also provide copies to the parents of the children in care for up to one year.

The deficiencies listed on the following pages were observed by the LPA and are being cited in accordance with California Code of Regulations Title 22. Please see attached LIC 809d. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.


*REPORT CONTINUES ON NEXT PAGE
SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Judy Mora
LICENSING EVALUATOR SIGNATURE: DATE: 05/06/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/06/2021
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 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: BENAVIDES FAMILY CHILD CARE
FACILITY NUMBER: 198006582
VISIT DATE: 05/06/2021
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
An exit phone interview has been conducted with Licensee Benavides. A copy of this report has been signed by LPA Mora. This report along with the LIC 9224 (Acknowledgement of Receipt of Licensing Report), and Appeal Rights will be e-mailed to the Licensee, who understands that an electronic “Read Receipt” and/or confirmation of receipt of the e-mail confirms receipt of the report and constitutes an electronic signature. A hard copy of this report and the Appeal Rights will be mailed out to the Licensee who agrees to sign the bottom of each page of the 9099 and return the originals to LPA Mora in-person or via U.S. Mail. The Notice of Site Visit is also being sent via email. Notice of Site Visit must be posted for 30 days failure to do so will result in an immediate civil penalty of $100.




*END OF REPORT
SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Judy Mora
LICENSING EVALUATOR SIGNATURE:

DATE: 05/06/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2021
LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 05/06/2021 03:40 PM - It Cannot Be Edited


Created By: Judy Mora On 05/06/2021 at 12:16 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: BENAVIDES FAMILY CHILD CARE
FACILITY NUMBER: 198006582

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/06/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/07/2021
Section Cited
CCR
102423(a)(4)

1
2
3
4
5
6
7
Personal Rights
Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. These rights include, but are not limited to, the following:
1
2
3
4
5
6
7
Licensee states she does not do that very often but she will not do it anymore. Licensee states she will just talk to the children and talk to the parents. Licensee will submit a written statement to LPA.
8
9
10
11
12
13
14
(4) To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature.
This requirement was not met as evidenced by children interviews conducted. Disclosures were made indicating that the children are made to stand in the corner when they are in trouble. This is an immediate risk to the health and safety of children in care.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
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:Judy Mora
LICENSING EVALUATOR SIGNATURE:
DATE: 05/06/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/06/2021


LIC809 (FAS) - (06/04)
Page: 3 of 3