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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198021149
Report Date: 02/19/2025
Date Signed: 02/19/2025 03:22:02 PM

Document Has Been Signed on 02/19/2025 03:22 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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:BARRIOS CHILD CAREFACILITY NUMBER:
198021149
ADMINISTRATOR/
DIRECTOR:		MARINA IVONNE BARRIOSFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 274-5664
CITY:PICO RIVERASTATE: CAZIP CODE:
90660
CAPACITY: 14TOTAL ENROLLED CHILDREN: 11CENSUS: 7DATE:
02/19/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:35 PM
MET WITH:Marina BarriosTIME VISIT/
INSPECTION COMPLETED:
03:35 PM
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Licensing Program Analyst (LPA) Veronica Martinez Garza conducted an unannounced Case Management Incident inspection at the above facility on 02/19/25 at 02:35 pm. The purpose of this inspection is to follow up on an incident reported to the Department on 02/03/25. LPA met with licensee, Marina Barrios who guided LPA on a tour of the facility. Census was taken.

During this inspection, LPA interviewed licensee. LPA couldn’t interview C1 since the child is non-verbal. LPA also conducted a file review for C1.

On 02/03/25 Child #1 (C1) child was sitting down on the floor of the living room putting all the blocks away on the Lakeshore bookshelf. Per licensee, the child tends to throw toys on the floor and likes to kick them. Licensee was helping the child place the toys on the shelf when the child kicked the last block with their right leg. Child hit the edge of the bookshelf. Licensee immediately evaluated the child’s foot and observed a little bit of blood on the toenail. Licensee applied ice on the foot and called C1s mom. C1 was taken to urgent care where it was confirmed that the child had a fracture on the pinky toe. Child returned to the facility on 02/10/25 and was given a soft cast though C1 never returned with the cast on. C1 had restrictions for outdoor play and or climbing. According to the licensee, C1 has behavioral, sensory, and verbal difficulties; however, licensee has been working with C1s mom and constantly communicating observations to better assist C1. LPA checked the Lakeshore bookshelf located in the living room and took pictures. LPA did not observe any potential hazards on the bookshelf. LPA reviewed C1s file and observed the unusual incident report, doctor's note, and pictures of the fractured toe.

At this time, the licensee is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued today.

The Notice of Site Visit (LIC 9213) must remain posted for 30 days during the hours of operation after each site visit by a licensing representative, a civil penalty of $100 can be assessed.

Exit interview conducted and report was reviewed with the licensee Marina Barrios.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE: DATE: 02/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/19/2025
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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