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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020057
Report Date: 01/29/2026
Date Signed: 01/29/2026 02:04:35 PM

Document Has Been Signed on 01/29/2026 02:04 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:CLARK FAMILY CHILD CAREFACILITY NUMBER:
198020057
ADMINISTRATOR/
DIRECTOR:		GAIL R. CLARKFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(213) 725-3696
CITY:CARSONSTATE: CAZIP CODE:
90746
CAPACITY: 14TOTAL ENROLLED CHILDREN: 25CENSUS: 11DATE:
01/29/2026
TYPE OF VISIT:Case Management - OtherANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:09 PM
MET WITH: Licensee / Gail Clark TIME VISIT/
INSPECTION COMPLETED:
02:15 PM
NARRATIVE
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Licensing Program Analyst (LPA) Ashley Calderon conducted an announced case management to address facility being over the ratio/capacity limit; that was observed during the previous visit conducted on 1/29/26 and to conduct a health and safety wellness check to the above facility. LPA met with Licensee Gail Clark and disclosed purpose of this visit.

LPA Calderon conducted a tour of the facility. During the pre-visit conducted at 9:10am, LPA Calderon observed 13 children, 4 who were infants. Per Interview conducted with Licensee informed LPA Calderon there was no children age 6 years old present or no child present that is enrolled in Traditional Kindergarten, Kindergarten, or Elementary. Based on this observation and record review facility was over Capacity Limits, deficiency cited. To stay in compliance,at 12:11pm 2 children were picked up, facility was left with 11 children (including 4 infants). LPA Calderon provided the Capacity/ Ratio Chart for Licensee/Staff to review and to adhere by limitations.

LPA Calderon observed outside area, no bodies of water observed and there is a off limit section that contains dogs in a gated kennel / fenced off area. LPA Calderon asked Licensee Clark regarding cleaning for the dog area, Licensee Clark informed LPA Calderon dog kennels get cleaned daily before overnight care children arrive and a cleaning service comes to clean dog area 2 a week.

Per Licensee Clark interview informed LPA Calderon facility is part of the food program and provides food per their age and portion required by the food program and children get seconds or more food when asked. LPA observed lunch time and each child was provided a meal. LPA Calderon reminded Licensee: If food is brought from the children's homes, the container shall be labeled with the child's name and properly stored or refrigerated.
NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Ashley Calderon
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 01/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/29/2026
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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Document Has Been Signed on 01/29/2026 02:04 PM - It Cannot Be Edited


Created By: Ashley Calderon On 01/29/2026 at 01:07 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: CLARK FAMILY CHILD CARE
FACILITY NUMBER: 198020057

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/29/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/30/2026
Section Cited
HSC
1597.465(d)(2)(a)(b)

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A large family day care home may provide care for more than 12 children and up to and including 14 children, if all of the following conditions are met:(a) At least one child is enrolled in and attending kindergarten or elementary school and a second child is at least six years of age.
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Durign today's visit: Two children were picked up at 12:11pm, leaving facility with 11 children (4 infants). LPA Calderon provided Licensee Clark Staffing Capacity and Ratio chart. Licensee Clark will submit a schedule on day time children and a schedule of the afternoon/ evening children once school age children are picked up with children.
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(b) No more than three infants are cared for during any time when more than 12 children are being cared for.
The requirement was not met as evidenced by: During the pre-visit conducted at 9:10am, LPA Calderon observed 13 children, 4 who were infants. Per Interview with Licensee Clark no Tk, Kindergarten or elementary and no child at least 6 years old present.
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Licensee will make changes and write changes to address that the facility will remain in compliance by poc due date.

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Warren Birks
NAME OF LICENSING PROGRAM MANAGER:
Ashley Calderon
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 01/29/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/29/2026


LIC809 (FAS) - (06/04)
Page: 3 of 4
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: CLARK FAMILY CHILD CARE
FACILITY NUMBER: 198020057
VISIT DATE: 01/29/2026
NARRATIVE
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LPA Calderon did not observe any foul odor of smoke. Per interview with Licensee, Staff assistants #1, #2 and #3 informed LPA Calderon not observed staff smoking on premises. LPA Calderon reminded Licensee: Smoking is prohibited on the premises of a family child care home.

Based on this information the following deficiency is on the LIC 809 D regarding capacity /ratio; are being cited today 1/29/26.

LPA Ashley Calderon informed licensee Gail Clark that this report dated 1/29/26 documents - with (1)Type A citation, which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Ashley Calderon informed the licensee Gail Clark to provide a copy of this licensing report dated 1/26/26 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report.

A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Ashley Calderon
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2026
LIC809 (FAS) - (06/04)
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