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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198009171
Report Date: 11/09/2021
Date Signed: 01/05/2022 11:56:41 AM

Document Has Been Signed on 01/05/2022 11:56 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:SANCHEZ FAMILY CHILD CAREFACILITY NUMBER:
198009171
ADMINISTRATOR:MARIA GUADALUPE SANCHEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 589-4046
CITY:HUNTINGTON PARKSTATE: CAZIP CODE:
90255
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 3DATE:
11/09/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Maria SanchezTIME COMPLETED:
01:40 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
This report is being amended to reflect appealed and dismissed deficiencies cited on November 09, 2021

Licensing Program Analyst (LPA) Elka Chavez conducted an unannounced Case Management-other inspection in Spanish to obtain additional information regarding a change in criminal record clearance for an adult residing in the home. LPA met with Licensee, Maria Sanchez who guided LPA on a tour of the facility. Also present was licensee's assistant, Shamila Sanchez. There were 3 children present during today’s inspection.

The purpose of today's inspection was to confirm the role of Gustavo Sanchez Garcia in the day care. LPA Chavez confirmed that Gustavo Sanchez Garcia does not reside in the home and does not assist with child care. LPA obtained a LIC 624 Unusual Incident Report from licensee during today's inspection.

Exit interview was conducted with Maria Sanchez.

A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Elka Chavez
LICENSING EVALUATOR SIGNATURE: DATE: 11/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/09/2021
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 2
Document Has Been Signed on 01/05/2022 11:57 AM - It Cannot Be Edited

Document is an Amendment of Original Document on 01/05/2022 08:32 AM


Created By: Elka Chavez On 11/09/2021 at 01:02 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: SANCHEZ FAMILY CHILD CARE
FACILITY NUMBER: 198009171

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/09/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/09/2021
Section Cited
CCR
102416.2

1
2
3
4
5
6
7
This report is being amended to reflect appealed and dismissed deficiencies cited on November 09, 2021
1
2
3
4
5
6
7
This report is being amended to reflect appealed and dismissed deficiencies cited on November 09, 2021
8
9
10
11
12
13
14
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:Karen Chambers
LICENSING EVALUATOR NAME:Elka Chavez
LICENSING EVALUATOR SIGNATURE:
DATE: 11/09/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/09/2021


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