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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198014720
Report Date: 04/02/2024
Date Signed: 04/02/2024 09:58:24 AM

Document Has Been Signed on 04/02/2024 09:58 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: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: 8CENSUS: 3DATE:
04/02/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Licensee, America Alcantar TIME COMPLETED:
10:15 AM
NARRATIVE
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At 9:10 am Licensing Program Analysts (LPAs) Roxana Lopez and Jessica Hopkins- Hernandez conducted an announced case management other inspection to the above facility on this date. LPAs met with America Alcantar, Licensee, who guided analysts on a tour of the facility. The purpose of this inspection is to ensure that Licensee is in compliance with previous citations cited on 3/30/2023 and 10/18/2023. There were 3 children present upon arrival. Also present during inspection was Licensee's Assistant.

At 9:20 am LPA's observed that Licensee did not have infant sleep logs for both infants enrolled. A copy of sleep log was provided on this date. Additionally, child # 1 was missing proof of Immunizations.

Based on the LPA’s 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 & safety.

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, America Alcantar.

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Roxana Lopez
LICENSING EVALUATOR SIGNATURE: DATE: 04/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/02/2024
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 04/02/2024 09:58 AM - It Cannot Be Edited


Created By: Roxana Lopez On 04/02/2024 at 09:37 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: 04/02/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/08/2024
Section Cited
CCR
102425(j)(1)

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102425(j)(1)Infant Safe Sleep-The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall physically check on the infant every 15 minutes. This requirement is not met as evidenced by:
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Per Licensee- they will beging documenting sleep as of today 4/2/2024 and will place documentation on file and submit of copy to LPA by 4/8/2024.
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Based on interview and record review, the licensee did not comply with the section cited above in that there was not sleep log documentation for 2 infants enrolled which poses/posed a potential health, safety or personal rights risk to persons in care.
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Type B
04/12/2024
Section Cited
CCR102418(a)

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(a) Prior to admission to a family day care home, children shall be immunized against diseases as required by the California Code of Regulations, Title 17, beginning with Section 6000. This requirement is not met as evideced by:
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 Per Licensee, she will request copies and place them in child's file
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Based on record review LPA observed that child # 1 is missing immunizations, which poses/posed a potential 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: 04/02/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/02/2024


LIC809 (FAS) - (06/04)
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