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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020044
Report Date: 08/28/2025
Date Signed: 08/28/2025 04:22:54 PM

Document Has Been Signed on 08/28/2025 04:22 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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:ALVAREZ LEIVA FAMILY CHILD CAREFACILITY NUMBER:
198020044
ADMINISTRATOR/
DIRECTOR:		ALVAREZ LEIVA,S & CARLOSFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 448-4169
CITY:DOWNEYSTATE: CAZIP CODE:
90240
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 3DATE:
08/28/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:34 PM
MET WITH:ALVAREZ LEIVA Licensee TIME VISIT/
INSPECTION COMPLETED:
04:35 PM
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On 8/28/25 Licensing Program Analysts (LPA) Tyler Reyes conducted an unannounced Annual/Random inspection at the above facility. LPA met with Licensee Siomara and Carlos Alvarez and provided an Entrance Checklist- Family Child Care homes LIC 126. LPA conducted a tour of the facility led by Licensee Siomara. LPA observed (3) children in care. Per Licensee hours of operation are Monday-Saturday 6am- 6am. LPA discussed with Licensee that “Overnight Care” means care being provided to children anytime between the hours of 6pm and 6am. Care provided during the day and overnight combined shall not exceed 24 hours from the time the child entered care. The facility is licensed to care for MAX. CAP(WHEN THERE IS AN ASSISTANT PRESENT): 12 - NO MORE THAN 4 INFANTS. CAP 14 - NO MORE THAN 3 INFANTS. 1 CHILD IN KINDERGARTEN OR ELEMENTARY SCHOOL AND 1 CHILD AT LEAST AGE 6. LPA discussed and provided copies of Capacity Regulations for Family Child Care Home License, Personnel Report LIC 500, and Child Care Facility Roster LIC 9040.

During the inspection, the following individuals were present in the home: Licensee Siomara, Carlos Alvarez, and Staff 1 (S1). All adults present in the home have obtained a criminal record clearance or exemption. LPA informed that any individual that has direct contact with the children and resides in the home is required to have a criminal record clearance or exemption.

Facility Postings: LPA observed required postings in entrance: Facility Licensee, PUB 394 Notification of Parents’ Rights, and LIC 9148 Earthquake Preparedness, and LIC 610A Emergency Disaster Plan. LPA discussed the documents to be posted in a prominent, publicly accessible area at facility. LPA provided an updated copy of PUB 394 and LIC 9148.

Emergency Disaster Drill: Fire/Earthquake Drill conducted 8/8/25

Pediatric CPR/First Aid in Pediatrics Certification: Licensee Siomara Completed 7/9/24 and Valid 07/26 from American Heart Association and S1 Completed 2/21/25 and Valid 02/27 from American Heart Association.

NAME OF LICENSING PROGRAM MANAGER: Karen Chambers
NAME OF LICENSING PROGRAM ANALYST: Tyler Reyes
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 08/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/28/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: ALVAREZ LEIVA FAMILY CHILD CARE
FACILITY NUMBER: 198020044
VISIT DATE: 08/28/2025
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Transportation: Per Licensee transportation is provided. A valid California Driver License of the licensee was observed with an expiration date of 1/11/2029.

Facility Sketch: The facility is a two-story home consist of a Front yard, day care room, living room, (4) restrooms, (5) bedrooms, backyard, pool, and attached garage.LPA observed a child safety fence separating the bottom floor from the top floor.

On Limit: Front yard, day care room, living room, (1) restroom, and backyard.

Off Limit: Kitchen, (4) bedrooms, (3) restroom, and garage.

Mandated Reporter Training Certificate: Based on record review Licensee Siomara and Carlos do not have a current Mandated Reporter Training Certificate which poses a potential health and safety risk. S1 Completed Mandated Reporter Training Certificate 4/11/25.

LPA observed a fire extinguisher in the day care room with an expired service tag August 7,2024 which poses a potential health and safety risk. Family Child Care Homes are required to maintain a new or serviced fully charged fire extinguisher which is at least a 2A:10BC annually. LPA observed an operable smoke and carbon monoxide detector. LPA observed multiple electrical outlets within the facility uncovered and unsecured which poses a potential health and safety risk.

LPA conducted an interview with Licensee regarding the following topics: infant safe sleep practices, the facility’s plan to support children’s learning and development, procedures for keeping parents informed, strategies for managing challenging behaviors, and protocols for managing food allergies. LPA discussed reporting requirements and the staff’s responsibilities as a mandated reporter, including the obligation to report to Community Care Licensing and emergency personnel when necessary.

Due to time constraints, LPA will return at a later date to complete the remaining CARE Tool domains. The Notice of Site Visit (LIC 9213)- must remain posted for 30 days consecutive days. Failure to maintain posting as required will result in a civil penalty of $100.00.

NAME OF LICENSING PROGRAM MANAGER: Karen Chambers
NAME OF LICENSING PROGRAM ANALYST: Tyler Reyes
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2025
LIC809 (FAS) - (06/04)
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