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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020501
Report Date: 03/10/2023
Date Signed: 03/10/2023 02:23:34 PM

Document Has Been Signed on 03/10/2023 02:23 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:CAMPOS FAMILY CHILD CAREFACILITY NUMBER:
198020501
ADMINISTRATOR:ROCIO CAMPOSFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 477-3742
CITY:MONTEBELLOSTATE: CAZIP CODE:
90640
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 10DATE:
03/10/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Licensee, Rocio CamposTIME COMPLETED:
02:40 PM
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Licensing Program Analyst (LPA) Mireya Garcia conducted an unannounced plan of correction visit to the above facility to ensure that the deficiencies cited on 03/02/2023 have been corrected. LPA met with Rocio Campos, Licensee, who guided analyst on a tour of the facility. Upon LPA’s arrival there were ten (10) children present with four (4) being infants. Licensee's assistant was also present during this inspection.
The following was observed:
  • The poison (Ant & Roach killer) product was observed to be stored in locked garage.
  • The cleaning compounds were observed to be under the kitchen sink cabinet with a safety latch in place.
  • The Excersaucer and baby bouncers were not observed in the daycare.
  • Licensee was observed to be within capacity; Four (4) infants and five (5) preschool age children present.
  • Infants were observed napping or if awake interacting with Licensee/Assistant.
  • Four playpens were observed readily available.
  • Child’s #1 enrollment documentation was reviewed and is on file.

Based on LPA's observation and information obtained during this inspection, the Type A and Type B deficiencies issued on 03/02/23 have been cleared. A Letter of Deficiency Citations Cleared was provided to the licensee during this inspection.

LPA also discuss and reviewed PIN 20-24-CCP Recently Approved Safe Sleep Regulations in Effect and Title 22 Regulation Section 102425(j) Infant Safe Sleep with Licensee and Assistant, including but not limited to documentation that shall be maintained.

At this time, the facility is in compliance. Therefore, no deficiencies are being cited 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 facility representative, Rocio Campos.
REPORT ENDS HERE PAGE 1 OF 1.
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Mireya Garcia
LICENSING EVALUATOR SIGNATURE: DATE: 03/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/10/2023
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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