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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020044
Report Date: 07/20/2023
Date Signed: 07/20/2023 02:42:23 PM

Document Has Been Signed on 07/20/2023 02:42 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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:ALVAREZ LEIVA FAMILY CHILD CAREFACILITY NUMBER:
198020044
ADMINISTRATOR:ALVAREZ LEIVA,S & CARLOSFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 448-4169
CITY:DOWNEYSTATE: CAZIP CODE:
90240
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 6DATE:
07/20/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
01:55 PM
MET WITH:Siomara AlvarezTIME COMPLETED:
03:00 PM
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Licensing Program Analysts (LPA) Elka Chavez conducted an unannounced Plan of Correction (POC) Inspection for the purpose of clearing citations from the 1-Year Required Inspection. LPA met with Siomara Alvarez, Licensee, who guided analyst on a tour of the facility. There were 6 children present during this inspection. LPA reviewed and received documentation requested to clear citations.

Licensee has corrected the following deficiencies:

· Section 102417(g)(5)(A) – The mesh fence has a gate that did not self-close or self-latch.


· Section 1596.8662(b)(1) - Staff #2 was missing proof of Mandated Reporter

LPA observed the gates swings away from the pool, self-closes and self-latches. The above deficiencies issued on 5/23/23 have been corrected and are being cleared today. Plan of Correction Letter was given on this date.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with Siomara Alvarez, Licensee
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Elka Chavez
LICENSING EVALUATOR SIGNATURE: DATE: 07/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/20/2023
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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