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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198012852
Report Date: 12/21/2022
Date Signed: 12/21/2022 10:05:49 AM

Document Has Been Signed on 12/21/2022 10:05 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:POOT-HERRERA & WALLDEZ FAMILY CHILD CAREFACILITY NUMBER:
198012852
ADMINISTRATOR:POOT-HERRERA & WALLDEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 726-0711
CITY:MONTEBELLOSTATE: CAZIP CODE:
90640
CAPACITY: 14TOTAL ENROLLED CHILDREN: 6CENSUS: 0DATE:
12/21/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Licensee, Evelyn WalldezTIME COMPLETED:
10:20 AM
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Licensing Program Analyst (LPA) Lilli Babcock conducted an unannounced POC (plan of correction) inspection to ensure that the Type B deficiency cited on 12/7/22 has been cleared. LPA met with Licensee, Evelyn Walldez, who guided analyst on a tour of the facility. There were no children present during this inspection. The following was observed:

· Smoke Detector and Carbon Monoxide detector were tested and were operable on this day


· LPA also observed a new fire extinguisher (30A-40BC) with a purchase date of 12/20/22
· LPA observed all needed forms in the children’s files

LPA advised the licensee how to access forms, regulations, and quarterly updates on the Child Care Licensing Website at: www.ccld.ca.gov.

LPA cleared the deficiency on this date and provided a copy of the Licensing Report to Evelyn Walldez. LPA also issued POC clearance letter during the visit.

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

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with Licensee, Evelyn Walldez.


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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Lilli Babcock
LICENSING EVALUATOR SIGNATURE: DATE: 12/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/21/2022
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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