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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019013
Report Date: 07/26/2024
Date Signed: 07/26/2024 02:02:47 PM

Document Has Been Signed on 07/26/2024 02:02 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:PEREZ FAMILY CHILD CAREFACILITY NUMBER:
198019013
ADMINISTRATOR/
DIRECTOR:
FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 20CENSUS: 8DATE:
07/26/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Carina Perez, Licensee TIME VISIT/
INSPECTION COMPLETED:
02:15 PM
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Licensing Program Analyst (LPA) Roxana Lopez conducted an unannounced poc (plan of correction) inspection to insured that the 2 Type A cited on 7/23/2024 have been cleared. LPA met with Carina who guided analysts on a tour of the facility. There were 8 children present during this inspection. The following was observed:

- LPA observed licensee operating within the capacity of the small license- with 8 children. Per Licensee the children enrolled during the summer will no longer be attending- and updated roster will be emailed to LPA.

- LPA did not observed any infants sleeping in rocking chairs- appropriate sleeping arrangements in form of playpen was observed. A current sleeping chart for infant present was also observed.

LPA advised that written plan to keep compliance still needs to be submitted by 7/30/2024.

Per Licensee, they are currently working on making copies of report and LIC 9224 acknowledgment form to provide to parents by the end of the date. Pending corrections include fire drill, POC due date of 8/2/2024 and Assistants Mandated Reporter Training certificate, POC due date of 8/23/2024.

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

LPA’s cleared deficiency on this date- LPA’s issued POC clearance letter during the visit.

During this inspection, 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, Carina Perez .

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Roxana Lopez
LICENSING EVALUATOR SIGNATURE: DATE: 07/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/26/2024
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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