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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198017533
Report Date: 09/07/2022
Date Signed: 09/07/2022 09:41:19 AM

Document Has Been Signed on 09/07/2022 09:41 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:HERRERA FAMILY CHILD CAREFACILITY NUMBER:
198017533
ADMINISTRATOR:HERRERA, JEANNETTEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 519-7143
CITY:MONTEBELLOSTATE: CAZIP CODE:
90640
CAPACITY: 14TOTAL ENROLLED CHILDREN: 8CENSUS: 3DATE:
09/07/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Assistant, Pompeya HerreraTIME COMPLETED:
10:00 AM
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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 06/15/2022 have been cleared. LPA met with Pompeya Herrera, Assistant who guided analyst on a tour of the facility. Licensee was not present during this inspection. There were three (3) children present during this inspection. The following has been observed:
  • LPA Garcia observed assistant within ratio (3 children).
  • LPA Garcia conducted records review of sleeping logs (June-Sept); documentation of visual checks of sleeping infants are recorded every 15 minutes.
  • LPA Garcia conducted staff records review and observed Certificate of completion for the Mandated Reporter Training AB1207 and immunization records (Pertussis, MMR & Influenza) were on file for Licensee & Assistant.

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 cleared deficiencies on this date and provided a copy of the Licensing Report to Pompeya Herrera, Assistant. 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, Pompeya Herrera.

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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