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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019583
Report Date: 07/22/2021
Date Signed: 08/21/2023 02:38:55 PM

Document Has Been Signed on 08/21/2023 02:38 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:CORTEZ FAMILY CHILD CAREFACILITY NUMBER:
198019583
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 14CENSUS: 6DATE:
07/22/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Licensee, Erica CortezTIME COMPLETED:
03:16 PM
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On July 22, 2021, an unannounced Case Management Inspection was conducted by Licensing Program Analyst (LPA) Jose Guzman regarding a pending application for an increase in capacity. A risk assessment was completed prior to entering the facility. The Licensee's assistant, husband, and two minor children were present. There were 7 children present. LPA met with Licensee Erica Cortez who guided LPA on an indoor and outdoor tour of the facility.

The Licensee is requesting an increase in capacity from 8 to 14 children. The Licensing Department received a granted Fire Clearance for a capacity of 14 children. During today's inspection, LPA toured the facility and did not observe any deficiencies regarding today’s inspection.

Areas to be used by children: Living room, one bathroom, and backyard.

Areas off-limits to children: two bedrooms, kitchen, dining area, front yard, and garage

The following was discussed: Individuals who are 18 years of age or older living in the home must obtain a criminal record clearance. Individuals within one month of their 18th birthday must be fingerprinted immediately. Failure to obtain a criminal record background check clearance prior to initial presence in the home will result in an immediate $100.00 dollar or more per day Civil Penalty.

Rooms that are off-limits need to be made inaccessible during operating hours. No smoking, No infant walkers, No Johnny jumpers, No saucer chairs, No trampolines, No baby bouncers, and any other item that falls into that category are not permitted in the facility. Effective January 1, 2010, licensees of family childcare homes are required to ensure that at least one staff member with current training in pediatric first aid and pediatric CPR is on site at all times when children are present.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Jose Guzman
LICENSING EVALUATOR SIGNATURE: DATE: 07/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/22/2021
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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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: CORTEZ FAMILY CHILD CARE
FACILITY NUMBER: 198019583
VISIT DATE: 07/22/2021
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Role and responsibilities of being a Mandated Reporter were reviewed. The Licensee was advised how to access forms and Regulations online at www.ccld.ca.gov. Licensee was made aware that it is her responsibility to know the regulations as well as anyone who assists in providing care.

The Licensee was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care. Sudden Infant Death Syndrome (SIDS), Effects of Lead Exposure, and Never-Shake-a-Baby were discussed.

LPA will recommend approval of the increase in capacity as the home meets Title 22 Code of Regulations and a fire clearance has been approved for a maximum capacity of 14 children.



At this time, the Licensee is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued today.

Upon receipt of this report, the Licensee shall post the Notice of Site Visit and any Licensing report documenting a type “A” deficiency. The report and the Notice of Site Visit shall be posted for 30 consecutive days. Failure to maintain posting as required, will result in an immediate $100 civil penalty.

Exit interview was conducted with Licensee Erica Cortez.


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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Jose Guzman
LICENSING EVALUATOR SIGNATURE:

DATE: 07/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2021
LIC809 (FAS) - (06/04)
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