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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020341
Report Date: 01/27/2025
Date Signed: 01/27/2025 11:38:56 AM

Document Has Been Signed on 01/27/2025 11:38 AM - 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:CHINCHILLA FAMILY CHILD CAREFACILITY NUMBER:
198020341
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 5CENSUS: 2DATE:
01/27/2025
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:55 AM
MET WITH:Licensee, Gladys Chinchilla TIME VISIT/
INSPECTION COMPLETED:
11:45 AM
NARRATIVE
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Licensing Program Analysts (LPA’s) Roxana Lopez and Kamile Martin conducted an unannounced POC (plan of correction) inspection to insured that the Type A deficiency cited on 1/24/2025 has been cleared. LPA’s met with Assistant Nora Chinchilla- who led analysts into the facility. Licensee, Gladys Chinchilla arrived at 11:10 am and took over the inspection. The following was observed:

- Licensee's un-fingerprinted adult son was not observed to be in the home- LPAs checked fingerprints status during the inspection and observed that son is now clear and associated to the facility.

- LPA's observed the LIC 9213 Notice of Site Visit posted along with the LIC 809 D listing the Type A deficiency cited. Per Licensee, they are still getting copies of reports and will provide parents with the report along with LIC 9224 acknowledgment form for them to signed.

LPA's advised the licensee how to access forms, regulations and quarterly updates on the Child Care Licensing Website at: www.ccld.ca.gov.

LPA’s cleared deficiency on this date and provided a copy of the Licensing Report to Gladys Chinchilla, licensee. LPA’s issued POC clearance letter during the visit.

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 Licensee, Gladys Chinchilla.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Roxana Lopez
LICENSING EVALUATOR SIGNATURE: DATE: 01/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/27/2025
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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