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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197407089
Report Date: 08/11/2026
Date Signed: 08/11/2026 04:30:40 PM

Document Has Been Signed on 08/11/2026 04:30 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:FLORES FAMILY CHILD CARE.FACILITY NUMBER:
197407089
ADMINISTRATOR/
DIRECTOR:		FLORES, LETICIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 623-4463
CITY:NORTH HOLLYWOODSTATE: CAZIP CODE:
91606
CAPACITY: 14TOTAL ENROLLED CHILDREN: 9CENSUS: 4DATE:
08/11/2026
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:01 PM
MET WITH:Leticia Flores, LicenseeTIME VISIT/
INSPECTION COMPLETED:
04:45 PM
NARRATIVE
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THIS INSPECTION WAS CONDUCTED IN BOTH ENGLISH AND SPANISH.

Licensing Program Analyst (LPA) Nathanael J. Mooberry and Licensing Program Manager (LPM) Rita Ramos conducted an unannounced case management inspection on 08/11/2026. LPA and LPM arrived at the facility at approximately 03:01PM and met with Leticia Flores, Licensee, who granted entrance and provided a tour of the facility. There were four (4) children in care and no assistant present upon arrival.

On 07/22/2026 LPA NJ Mooberry conducted a visit to obtain a copy of a roster. It has been determined that Child #1 was enrolled at the facility on 06/16/21 but was not listed on the facility roster on 07/17/26 which is a potential risk for children in care. LPA and LPM reminded Licensee that the roster indicates that it needs to be retained for 3 years.

Due to Child #1 not listed on the roster, a Type B deficiency is being cited on the attached deficiencies page.

LPA's visit on 07/22/26 pertained to an investigation conducted by the Department's Investigation Branch (IB) in which Information provided by IB was that Child #1 was placed in a situation that violated their personal rights by being placed in an uncomfortable environment which is an immediate health & safety and personal rights risk to children in care.



Due to the violation of personal rights, a Type A violation is being cited on the attached deficiencies page.

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Rita Ramos
Nathanael Mooberry
DATE: 08/11/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/11/2026
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 5
California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: FLORES FAMILY CHILD CARE.
FACILITY NUMBER: 197407089
VISIT DATE: 08/11/2026
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THIS INSPECTION WAS CONDUCTED IN BOTH ENGLISH AND SPANISH.

LPA informed licensee that this report dated 08/11/2026 documents a Type A citation. Type A citations shall be posted for 30 consecutive days as there is immediate risk to the health and safety of children in care

Also, LPA informed the licensee to provide a copy of this licensing report dated 08/11/2026 that documents this Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

During the course of the investigation conducted by IB, the Licensee's file was reviewed and it was determined the documents in the file need to be updated. Licensee confirmed they are open 7 days a week, 24 hours a day. Since this facility is located on the same lot as Trinidad FCC (Facility# 197409369), LPA and LPM are requesting that licensee submit the following updated documents by 08/25/2026:

  • Update Facility sketch to indicate indoor, outdoor, upstairs, downstairs, garage showing the other two properties, which are 11830 and 11832 Mamlin St, North Hollywood.
  • Updated LIC 610 Emergency Disaster Plan to note relocation sites that are not on the same lot.
  • Control of Property
  • Declaration noting who lives and resides at 11830 1/2, 11830, and 11832 Hamlin St, North Hollywood due to licensee, Leticia Flores, stating that she co-owns all three properties.

During this visit, LPA and LPM requested if licensee would allow LPA and LPM to tour the property 11830, since they disclosed that they co-own the property with the Licensee, Trinidad, from Trinidad FCC # 197409369 and disclosing that their assistant resides in 11830. Licensee Leticia Flores declined.

A "Notice of Site Visit" and copy of the report was issued. Notice of Site Visit must remain posted for 30 days. Failure to do so will result in a $100.00 civil penalty.

Exit interview was conducted, and report and appeal rights provided to Leticia Flores, Licensee.

NAME OF LICENSING PROGRAM MANAGER: Rita Ramos
NAME OF LICENSING PROGRAM ANALYST: Nathanael Mooberry
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/11/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2026
LIC809 (FAS) - (06/04)
Page: 3 of 5
Document Has Been Signed on 08/11/2026 04:30 PM - It Cannot Be Edited


Created By: Nathanael Mooberry On 08/11/2026 at 03:32 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
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: FLORES FAMILY CHILD CARE.
FACILITY NUMBER: 197407089

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/11/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/12/2026
Section Cited
CCR
102423(a)(2)

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102423 Personal Rights
(a) Each child receiving services from a family child care home shall...
(2) ...receive safe, healthful, and comfortable accommodations.
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Per licensee, plan of correction will be submitted to LPA by POC due date, 08/12/2026.
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This reqirement was not met as evidenced by Child #1 being placed in a situation that violated their personal rights by being placed in an uncomfortable environment which is an immediate health & safety and personal rights risk to children in care.
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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.
Rita Ramos
NAME OF LICENSING PROGRAM MANAGER:
Nathanael Mooberry
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 08/11/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/11/2026


LIC809 (FAS) - (06/04)
Page: 4 of 5
Document Has Been Signed on 08/11/2026 04:30 PM - It Cannot Be Edited


Created By: Nathanael Mooberry On 08/11/2026 at 03:36 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
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: FLORES FAMILY CHILD CARE.
FACILITY NUMBER: 197407089

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/11/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/12/2026
Section Cited
CCR
102417(g)(8)

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102417 Operation of a Family Child Care Home
(g) (8) Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841.
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Per licensee,an updated roster will be submitted to LPA by POC due date, 08/12/2026.
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This reqirement was not met as evidenced by Child #1 was enrolled at the facility on or before 07/17/26 but was not listed on the facility roster which is a potential risk for children in care.
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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.
Rita Ramos
NAME OF LICENSING PROGRAM MANAGER:
Nathanael Mooberry
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 08/11/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/11/2026


LIC809 (FAS) - (06/04)
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