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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400251
Report Date: 08/20/2024
Date Signed: 08/20/2024 03:23:04 PM

Document Has Been Signed on 08/20/2024 03:23 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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:CUEVAS FAMILY CHILD CAREFACILITY NUMBER:
198400251
ADMINISTRATOR/
DIRECTOR:
MARIA DE JESUS CUEVASFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 453-5528
CITY:LYNWOODSTATE: CAZIP CODE:
90262
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 3DATE:
08/20/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:45 PM
MET WITH:Maria De Jesus Cuevas, LicenseeTIME VISIT/
INSPECTION COMPLETED:
03:40 PM
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Licensing Program Analysts (LPAs) Portia Bowden and Jeanette Estrada Conducted an Unannounced Annual Inspection at the above facility on 08/20/2024 at 1:45PM. Upon arrival, LPAs met with Licensee, Maria De Jesus Cuevas, provided her with an LIC 126 Entrance checklist and were guided on tour of the facility. Adults in the home were discussed and all have criminal record clearance. There were 3 children present during today’s inspection, two who are enrolled in daycare. Licensee states there are four children currently enrolled. The children's roster was reviewed and is current. Per Licensee, the facility’s hours of operation are Monday thru Friday, 6:00 AM to 10:00 PM. Emergency Disaster Plan, License, and Parents’ Rights were posted at the time of inspection. Disaster drill log was also available during today’s inspection, last disaster drill conducted on 08/12/24.

This is a single-story home which consists of three bedrooms and two bathrooms, kitchen, living room, dining room, and detached garage. Garage is currently under construction to become an Additional Dwelling. Per Licensee, construction workers do not have access to the main home or contact with children in care. Areas accessible to children include the Living Room (located upon entry of the home), Dining Room (located next to Living Room), and Bathroom 1 (located to the left of Living Room). Per Licensee, areas off limits to children and parents include kitchen and entire rear of home that includes all bedrooms and Bathroom 2. At 2:00PM LPAs observed a baby gate separating areas used by children and off-limits area.

All areas identified on the facility sketch as accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for the safety of the children. At 2:05 PM LPAs observed central air and ceiling fans through out the home. There is a working telephone maintained in the home. At 2:07 LPAs observed Living Room to have two couches, play kitchen, tall doll house, and other age appropriate toys, free of loose and sharp parts available for children. At 2:10 PM LPAs observed Two Graco Pack-n-Plays and one wooden crib in Living Room used for Infant sleep.
Report continues- Page 1 of 4
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Portia Bowden
LICENSING EVALUATOR SIGNATURE: DATE: 08/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/20/2024
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 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: CUEVAS FAMILY CHILD CARE
FACILITY NUMBER: 198400251
VISIT DATE: 08/20/2024
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At 2:15 PM LPAs observed dining table with four chairs, shelving unit with bins filled with art materials, board games, and other age appropriate toys. At 2:20PM LPAs observed Bathroom 1 to have operable toilet and sink, adequate handwashing and toileting supplies, floor free of hazards, under cabinet sink to have operable child safety lock, medicine cabinet used for storing toothbrushes, and storage unit over toilet to have toileting supplies. LPAs observed electrical cover outlets all through the home. Detergents, cleaning compounds, medications, sharp knives and utensils, and other items which can pose a danger to children are inaccessible. LPAs observed knives and cleaning compounds to be stored in the off limits Kitchen area with operable child safety locks. Per Licensee personal medication is stored in an off limits bedroom and no children enrolled currently require medication. Per Licensee, detergents are stored in an upper shelf in the laundry area in the hallway. LPAs observed a safety gate separating the hallway to the off limit bedrooms and laundry area and the kitchen. The Licensee states that there are no poisons in the home. The Licensee does understand that poison must be locked with a key or combination lock. Per Licensee, they provide food for children in care.

Per Licensee, the children will have access to the front yard area for outdoor play. At 2:30 PM, LPAs observed front yard to be free and clear of hazards or sharp edges. Home has adequate perimeter fencing through-out the yard. At 2:35 PM, LPAs observed there is a pool in the backyard of the home. Licensee states rear of the backyard is off limits to children in care. At 2:35 PM, LPAs observed a gate 5 feet tall, with door swinging outward to have self latching lock and to be locked with a key at time of inspection.


At 2:40 PM LPAs observed the valve on the required 2A 10BC fire extinguisher indicates fully charged with proof of purchase receipt on 06/02/23. LPAs advised Licensee to obtain new extinguisher or have existing one serviced. At 2:45PM LPAs observed smoke and carbon monoxide detectors are in operable condition. At 2:47 LPAs observed first Aid kit is kept in the Kitchen. The Licensee has current Pediatric First Aid and CPR. Proof of immunization against influenza, pertussis, and measles was readily available during today’s inspection. The Licensee has also taken the Mandated reporter training.
—CPR Card valid until: 6/26
—Mandated Reporter AB1207 Completed: 5/5/23
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SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Portia Bowden
LICENSING EVALUATOR SIGNATURE:

DATE: 08/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2024
LIC809 (FAS) - (06/04)
Page: 2 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: CUEVAS FAMILY CHILD CARE
FACILITY NUMBER: 198400251
VISIT DATE: 08/20/2024
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At 2:50 PM, LPAs reviewed children and staff files and observed them to be complete.

Per Licensee, she does not provide incidental medical services at the moment, there are no weapons or firearms in the home.
Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

LPAs discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.
Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

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SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Portia Bowden
LICENSING EVALUATOR SIGNATURE:

DATE: 08/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2024
LIC809 (FAS) - (06/04)
Page: 4 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: CUEVAS FAMILY CHILD CARE
FACILITY NUMBER: 198400251
VISIT DATE: 08/20/2024
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During the exit interview, Maria Cuevas confirmed that there are no Registered Sex Offenders living in the facility and LPAs completed the RSO profile in FAS.

One TV deficiency is being cited today on page LIC 809-D for expired Fire Extinguisher.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee Maria Cuevas.

End of Report Page 4 of 4
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Portia Bowden
LICENSING EVALUATOR SIGNATURE:

DATE: 08/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2024
LIC809 (FAS) - (06/04)
Page: 3 of 4