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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400836
Report Date: 07/23/2024
Date Signed: 07/23/2024 02:21:49 PM

Document Has Been Signed on 07/23/2024 02:21 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:FERNANDEZ SILVA FAMILY CHILD CAREFACILITY NUMBER:
198400836
ADMINISTRATOR/
DIRECTOR:		FERNANDEZ SILVA, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
5622741630
CITY:NORWALKSTATE: CAZIP CODE:
90650
CAPACITY: 14TOTAL ENROLLED CHILDREN: 24CENSUS: 8DATE:
07/23/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:40 PM
MET WITH:Maria Fernandez-SilvaTIME VISIT/
INSPECTION COMPLETED:
02:30 PM
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Licensing Program Analyst (LPA) T. Tran arrived at above licensed facility to conduct an unannounced Case Management incident inspection that was self-reported on 07/08/2024. The Monterey Park Southwest Childcare Regional Office received the incident report on 7/06/2024. LPA met licensee, Maria Fernandez-Silva, her licensee's husband Ramon Fernandez-Silva, licensee's employees with 8 children in care. LPA observed proper care and supervision.

LPA completed child's file review and obtained child's record. Based on the information that were gathered through interviews with licensee and other. On the day of the incident, there were licensee and licensee's husband with 6 children in care. Per licensee, on 7/6/24, C1 observed to be normal and did not show any signs of distress while in car. On 7/7/24, C1's parent informed licensee that C1 had a broken elbow and needed to wear a cast for three days. On 7/12/24, parent bought C1 came to visit the home without any restrictions and able to return to the daycare. Parent of C1 did not have any concerns of the level of care and supervision. According to the available information, it does not appear this incident was the result of a Title 22 violation for personal rights.

No deficiency was cited at this time. A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the facility representative, Maria Fernandez-Silva.

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Tiffanie Tran
LICENSING EVALUATOR SIGNATURE: DATE: 07/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/23/2024
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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