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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020316
Report Date: 07/19/2024
Date Signed: 07/19/2024 04:14:12 PM

Document Has Been Signed on 07/19/2024 04:14 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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:FLORES FAMILY CHILD CAREFACILITY NUMBER:
198020316
ADMINISTRATOR/
DIRECTOR:		CYNTHIA FLORESFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 347-0133
CITY:WHITTIERSTATE: CAZIP CODE:
90604
CAPACITY: 14TOTAL ENROLLED CHILDREN: 13CENSUS: 10DATE:
07/19/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:00 PM
MET WITH:Licensee, Cynthia Flores TIME VISIT/
INSPECTION COMPLETED:
04:25 PM
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Licensing Program Analysts (LPAs) Roxana Lopez and Saul Valenzuela conducted a Case Management Deficiencies visit on this date to address deficiencies revealed during a Complaint inspection. Census was taken.

LPAs arrived at 2:00 pm to deliver findings for a complaint and observed children sleeping and resting in the living room area. At 2:20 pm LPA Lopez enter the facilities bathroom LPA observed through the bathroom window that the pool gate was propped opened with a car battery, LPA Valenzuela walked into the bathroom and observed that the gate was closed but can still see the battery on the open side gate. When all the children got up from nap LPA Lopez asked to see the backyard- and observed that gate was closed and battery was on the other side of the pool with gate open. During inspection Licensee closed pool gate and placed car battery in an off- limits area. LPA advised that this was an immediate risk for children in care.
LPAs did observed a sign stating that pool day are on Wednesday and Friday. Per Licensee, they were using the pool before nap and did not close the gate.

Based on LPA observations, the following deficiencies listed on the attached LIC 809D (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health and safety

LPAs Roxana Lopez and Saul Valenzuela informed Licensee Cynthia Flores that this report dated 7/19/2024 document(s) 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, LPAs Roxana Lopez --------------------------------------------------------- pg. 1 of 2 -------------------------------------------------------
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Saul Valenzuela
LICENSING EVALUATOR SIGNATURE: DATE: 07/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/19/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: FLORES FAMILY CHILD CARE
FACILITY NUMBER: 198020316
VISIT DATE: 07/19/2024
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and Saul Valenzuela informed the Licensee to provide a copy of this licensing report dated 7/19/2024 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.

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 the Licensee Cynthia Flores.
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Saul Valenzuela
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 07/19/2024 04:14 PM - It Cannot Be Edited


Created By: Saul Valenzuela On 07/19/2024 at 03:23 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: FLORES FAMILY CHILD CARE
FACILITY NUMBER: 198020316

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/19/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/19/2024
Section Cited
CCR
102417(5)

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(5) All licensees shall ensure the inaccessibility of pools (in-ground and above-ground), fixed-in-place wading pools, hot tubs, spas, fish ponds and similar bodies of water through a pool cover or by surrounding the pool with a fence. This requirement was not met as evidenced by
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During inspection Licensee closed the pool gate and placed car battery in an off limits area. Per Licensee, she will meet with her staff and submit a written plan on how they will maintain the pool innacesible to children in care. Plan will be submitted to LPA by 722/24 via email.
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Based on observation the Licensee did not copmly with the section cited above in that LPA's observed that the swimming pool was propped opened with a car battery. This poses an imediate risk to the health and safety of children in care.
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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.
SUPERVISOR'S NAME:Brandi VanOosten
LICENSING EVALUATOR NAME:Saul Valenzuela
LICENSING EVALUATOR SIGNATURE:
DATE: 07/19/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/19/2024


LIC809 (FAS) - (06/04)
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