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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400632
Report Date: 03/30/2023
Date Signed: 03/30/2023 03:16:10 PM

Document Has Been Signed on 03/30/2023 03:16 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 S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:CONTRERAS FAMILY CHILD CAREFACILITY NUMBER:
198400632
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 5CENSUS: 5DATE:
03/30/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Licensee - Ericka ContrerasTIME COMPLETED:
03:30 PM
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Licensing Program Analyst (LPA) R. Derraco conducted a case management visit to the above mentioned facility on 03/30/23. LPA was met with Licensee, Ericka Contreras, who guided licensee on a tour of the facility. Also present during this inspection was assistant, S2. The purpose of this visit is to observe changes to the facility sketch. Licensee states she will now use the backyard as an outdoor play area. LPA observed 5 children in care. The home was observed to be clean and in good repair.

LPA observed a white baby gate separating the off-limits area of the backyard from the play area. Each side of the gate was observed to be screwed into the wall. Perimeter fencing was observed throughout the backyard. A wooden climbing structure with two swings and a slide were observed in the play area. LPA observed the structure on the grass area of the back yard. The wooden structure was observed to be smooth and free of splinters. LPA observed two wooden square posts at the end of the swing section of the structure.

Prior to use of outdoor play area and climbing structure, licensee must make the following corrections:
-corners of the two wooden square posts must be made inaccessible to children in care
-updated facility sketch showing new off-limit areas and accessible areas of back yard.

Licensee states she will email pictures of the corrections and and updated facility sketch to LPA.

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

Exit interview conducted and report was reviewed with the licensee Ericka Contreras.
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE: DATE: 03/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/30/2023
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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