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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198009597
Report Date: 10/12/2022
Date Signed: 10/12/2022 04:06:51 PM

Document Has Been Signed on 10/12/2022 04:06 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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:BONILLA FAMILY CHILD CAREFACILITY NUMBER:
198009597
ADMINISTRATOR:LILLIAN BONILLAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 923-1430
CITY:DOWNEYSTATE: CAZIP CODE:
90241
CAPACITY: 14TOTAL ENROLLED CHILDREN: 8CENSUS: 5DATE:
10/12/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:20 PM
MET WITH:Lillian BonillaTIME COMPLETED:
04:10 PM
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Licensing Program Analyst (LPA) T. Tran arrived at Bonilla Family Childcare to conduct a Case Management inspection that was self-reported on 09/27/2022 regards a personal rights concern for a child in care. Upon arrival, LPA toured the home indoor and outdoor and observed proper care and supervision.

File review was completed. LPA obtained the children's roster, child’s record, and CPR Certificate. LPA interviewed licensee. On the day of the incident, there were 6 children enrolled. Due to insufficient information available at this time, the above allegations need further investigation.

No deficiency was cited at this time. A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the facility representative, Lillian Bonilla.

SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Tiffanie Tran
LICENSING EVALUATOR SIGNATURE: DATE: 10/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/12/2022
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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