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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400016
Report Date: 06/19/2024
Date Signed: 06/19/2024 04:26:04 PM

Document Has Been Signed on 06/19/2024 04:26 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:MANZO FAMILY CHILD CAREFACILITY NUMBER:
198400016
ADMINISTRATOR/
DIRECTOR:		MARIA MANZOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 706-9033
CITY:LYNWOODSTATE: CAZIP CODE:
90262
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 8DATE:
06/19/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:30 PM
MET WITH:MARIA MANZO / LICENSEETIME VISIT/
INSPECTION COMPLETED:
04:45 PM
NARRATIVE
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Inspection conducted in Spanish by LPA A. Calderon

Licensing Program Analysts (LPAs) Ashley Calderon and Angelica Wallin conducted an unannounced case management - other. LPAs where at the facility conducting a complaint investigation. LPAs met with licensee Maria Manzo. During inspection, LPAs observed 8 children and two staff present. During inspection, LPAs observed proper supervision and ratio.

On 5/15/24 LPA Wallin provided facility with deficiencies. During today's visit LPA's requested completed staff records and children's records. Licensee was unable to provide the following documents during LPA's record review request: one assistant's immunization records, TB clearance for licensee, complete children's record for all enrolled children with parent signatures and an updated mandated reporter certificate for licensee and all staff.

The following deficiencies listed on the attached LIC 809-D (deficiency page) are being cited in accordance with California Code of Regulations Title 22, and (3) civil penalty was provided today due to Licensee records found incompliance and repeat violations are being cited on LIC421FC's.

A notice of site visit was given and must remain posted for 30 days. Appeal Rights were given and explained. Exit interview conducted and report was reviewed with the Licensee Maria Manzo.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Ashley Calderon
LICENSING EVALUATOR SIGNATURE: DATE: 06/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/19/2024
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
Document Has Been Signed on 06/19/2024 04:26 PM - It Cannot Be Edited


Created By: Ashley Calderon On 06/19/2024 at 03:49 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: MANZO FAMILY CHILD CARE
FACILITY NUMBER: 198400016

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/19/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/19/2024
Section Cited
HSC
102421(a)

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The licensee shall maintain, in each child's record, the signed and dated notice form required in Section 102419(d).

This requirement was not met as evidenced by:
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Per licensee, will complete and have parents sign children's records to be obtained and evidence proof of completed children's records to be submitted via email LPA Wallin.
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Per children record review, LPA observed four children’s record missing and incomplete without parent or parent representative signatures.
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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:Valarie Cook
LICENSING EVALUATOR NAME:Ashley Calderon
LICENSING EVALUATOR SIGNATURE:
DATE: 06/19/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/19/2024


LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 06/19/2024 04:26 PM - It Cannot Be Edited


Created By: Ashley Calderon On 06/19/2024 at 03:49 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: MANZO FAMILY CHILD CARE
FACILITY NUMBER: 198400016

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/19/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/19/2024
Section Cited
HSC
1596.8662(a)(2)

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Provide training including statewide guidance on the responsibilities of a mandated reporter who is a licensed day care provider or an applicant for that license, administrator, or employee of a licensed child day care facility in accordance with the Child Abuse and Neglect Reporting.
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Per licensee, mandated reporter certificates for all staff to be completed and evidence proof of completed certificates to be submitted via email to LPA Wallin by POC due date.
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This requirement was not met as evidenced by: Per staff record review, LPAs Wallin and Calderon observed licensee needs mandated reporter training for licensee and (2) assistants.
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Type B
07/19/2024
Section Cited
HSC1596.7995(a)(1)

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Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.
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Per licensee, immunization's for all staff to be obtained and evidence proof of obtained immunization's to be submitted via email by POC due date.
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This requirement was not met as evidenced by: Per staff record review, LPA's Wallin and Calderon observed licensee missing TB immunization and two staff missing immunization's for measles, pertussis, influenza and TB clearance.
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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:Valarie Cook
LICENSING EVALUATOR NAME:Ashley Calderon
LICENSING EVALUATOR SIGNATURE:
DATE: 06/19/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/19/2024


LIC809 (FAS) - (06/04)
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