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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198011855
Report Date: 09/07/2022
Date Signed: 09/07/2022 03:45:14 PM

Document Has Been Signed on 09/07/2022 03:45 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:VARGAS FAMILY CHILD CAREFACILITY NUMBER:
198011855
ADMINISTRATOR:VARGAS, AGUEDAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 887-4002
CITY:MONTEBELLOSTATE: CAZIP CODE:
90640
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 11DATE:
09/07/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Licensee, Agueda VargasTIME COMPLETED:
04:00 PM
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Licensing Program Analyst (LPA) Mireya Garcia conducted an unannounced POC (Plan of Correction) inspection to ensure that the Type A and B deficiencies cited on 08/11/2022 have been cleared. LPA met with Augeda Vargas, Licensee who guided analyst on a tour of the facility. Licensee's assistants and elderly mother were also present during this inspection. There were eleven (11) children present during this inspection with two (2) being infants. The following has been observed:
  • LPA Garcia observed poisons to be stored in cabinet with locked pad lock.
  • LPA observed Licensee/assistants within ratio (11 children).
  • LPA observed secured safety gate below the stairs that lead to the second floor.
  • LPA observed fire extinguisher fully charged with a service tag dated 08/12/2022.
  • LPA conducted records review of sleeping logs (Aug-Sept); documentation of visual checks of sleeping infants are recorded every 15 minutes.
  • LPA Garcia conducted staff records review and observed Immunization records (Pertussis, MMR & Influenza) were on file for Licensee & Assistants.
  • LPA Garcia conducted records review of LIC700 Identification and Emergency Information which were on file for Child #12 & #13, Child #1 not available since child no longer attends day care since 08/11/22.

At this time, the licensee is in compliance with California Code of Regulations Title 22. Therefore, no deficiencies are being cited during today’s inspection.

LPA Garcia cleared deficiencies on this date and provided a copy of the Licensing Report to Agueda Vargas, Licensee. LPA issued POC clearance letters during the visit. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with facility representative, Agueda Vargas.
Report ends here page 1 of 1.
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Mireya Garcia
LICENSING EVALUATOR SIGNATURE: DATE: 09/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/07/2022
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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