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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198014720
Report Date: 10/16/2023
Date Signed: 10/16/2023 12:26:59 PM

Document Has Been Signed on 10/16/2023 12:26 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:ALCANTAR FAMILY CHILD CAREFACILITY NUMBER:
198014720
ADMINISTRATOR:ALCANTAR, AMERICAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 373-4091
CITY:SOUTH EL MONTESTATE: CAZIP CODE:
91733
CAPACITY: 14TOTAL ENROLLED CHILDREN: 11CENSUS: 8DATE:
10/16/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Licensee America Alcantar TIME COMPLETED:
12:40 PM
NARRATIVE
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Licensing Program Analyst (LPAs) Roxana Lopez and Staicy Perry conducted a Case Management-Deficiencies visit on this date to address deficiencies revealed during a complaint inspection. A COVID risk assessment was conducted upon entry.

LPA's initially arrived to the facility at 10:50 am- upon arrival LPA's observed assistant with 8 children 3 being infants, the oldest being 3 years old making her out of ratio. This poses an immediate risk for children in care. LPA advised assistant that when there's not 2 fully qualified adults. providers must follow Small Family Child Care home regulations- 8 children no more than 2 infants and 6 older children at least 2 school age children.

Additionally, during a prior incident investigation it was determined that the off-limits front yard has been used for day care use without notifying the department.

At 11:30 am LPA's reviewed files of children present- LPA's observed that child # 7 and child # 8 did not have a file for review.

Based on LPA observations and records review, the following deficiencies listed on the attached LIC 809D (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health and safety.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Roxana Lopez
LICENSING EVALUATOR SIGNATURE: DATE: 10/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/16/2023
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 4
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: ALCANTAR FAMILY CHILD CARE
FACILITY NUMBER: 198014720
VISIT DATE: 10/16/2023
NARRATIVE
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LPAs Roxana Lopez and Staicy Perry informed licensee America Alcantar that this report dated 10/16/2023 document(s) 1 Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPAs Roxana Lopez and Staicy Perry informed the licensee America Alcantar to provide a copy of this licensing report dated 10/16/2023. that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

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 the Licensee, America Alcantar

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Roxana Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 10/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2023
LIC809 (FAS) - (06/04)
Page: 2 of 4
Document Has Been Signed on 10/16/2023 12:26 PM - It Cannot Be Edited


Created By: Roxana Lopez On 10/16/2023 at 11:43 AM
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: ALCANTAR FAMILY CHILD CARE
FACILITY NUMBER: 198014720

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/16/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/16/2023
Section Cited
CCR
102416.5(e)

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102416.5 Staffing Ratio and Capacity(e) If no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home as specified in subsections (b) and (c). This requirement is not met as evidenced by:
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Licensee, arrived within 10 minutes of inspection. Per Licensee, they will not leave assistant out of ratio. Licensee and Assitant will watch ratio and capacity video at ccld.childcarevideos.org they will submit a decleration on what they've learned and plan moving forward to LPA by 10/23/2024
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Based on observation and interview, the licensee did not comply with the section cited above in that LPA's observed assistant by herself with 8 children 3 being infants, which poses an immediate health, safety or personal rights risk to persons in care.
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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:Brandi VanOosten
LICENSING EVALUATOR NAME:Roxana Lopez
LICENSING EVALUATOR SIGNATURE:
DATE: 10/16/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/16/2023


LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 10/16/2023 12:26 PM - It Cannot Be Edited


Created By: Roxana Lopez On 10/16/2023 at 11:50 AM
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: ALCANTAR FAMILY CHILD CARE
FACILITY NUMBER: 198014720

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/16/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/27/2023
Section Cited
CCR
102417(g)(7)

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102417(g)The home shall be free... conditions which might endanger a child. Safety precautions shall include but not be limited to:(7)An emergency information card shall be maintained for each child and shall include the child's full name, telephone number and location of
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Per Licensee, they will request complete files for children # 7&8 and have them available for department review by POC due date of 10/27/2023
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a parent or other responsible adult to be contacted in an emergency...This requirement was not met as evidence by Based on record review, the licensee did not comply with the section cited above in that Child # 7 & 8 are missing complete files, which poses/posed a potential
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health, safety or personal rights risk to persons in care.
Type B
10/27/2023
Section Cited
CCR102416.3(a)(6)

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102416.3 (a)Prior to making alterations or additions to a family child care home or grounds, the licensee shall notify the Department of the proposed changed, including, but not limited to, the following:(6) Any change from an area of the family child care home previously identified as
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Per Licensee, they will submit an updated outdoor sketch updating areas used for children in care by POC due date of 10/27/2023
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"off limits" to an area where care and supervision will be provided to children in care. This requirement was not met as evidenced by: Based on interviews and record review, the licensee did not comply with the section cited above in that the off-limits front yard has been
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used for daycare use without notifying the department, which poses/posed a potential health, safety or personal rights risk to persons in care.
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:Brandi VanOosten
LICENSING EVALUATOR NAME:Roxana Lopez
LICENSING EVALUATOR SIGNATURE:
DATE: 10/16/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/16/2023


LIC809 (FAS) - (06/04)
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