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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 192008660
Report Date: 10/01/2021
Date Signed: 10/01/2021 04:14:01 PM

Document Has Been Signed on 10/01/2021 04:14 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:PRIETO FAMILY CHILD CAREFACILITY NUMBER:
192008660
ADMINISTRATOR:PRIETO, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 233-2459
CITY:LOS ANGELESSTATE: CAZIP CODE:
90037
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 9DATE:
10/01/2021
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
04:00 PM
MET WITH:Mirsa Prieto, Facility RepresentativeTIME COMPLETED:
04:30 PM
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Licensing Program Analysts (LPA) Denise Gibbs conducted an unannounced case management inspection to the above facility on 10/1/21 at 11:30 AM. LPA met with Mirsa Prieto, Licensee, who guided analysts on a tour of the facility. The purpose of this inspection is to follow-up on deficiencies cited on 9/23/21.

During inspection LPA observed nine children, one adult staff and one adult resident present in home. LPA toured the facility. LPA observed that the gate in the off limits kitchen is back up making the kitchen area inaccessible. The knives and medication previously observed were placed in an inaccessible area. The door to the garage was closed and locked upon arrival and all chemicals hazardous to children were stored inaccessible to children in care.

There will be no deficiencies cited today 10/1/2021.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days.

Exit interview was conducted with Mirsa Prieto, Facility Representative, during which appeal rights were explained. This report along with a copy of the appeal rights was provided.
SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Denise Gibbs
LICENSING EVALUATOR SIGNATURE: DATE: 10/01/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/01/2021
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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