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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198006610
Report Date: 09/15/2026
Date Signed: 09/15/2026 12:27:20 PM

Document Has Been Signed on 09/15/2026 12:27 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:BUTLER FAMILY DAY CAREFACILITY NUMBER:
198006610
ADMINISTRATOR/
DIRECTOR:		BUTLER, PATRICIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 223-3132
CITY:CARSONSTATE: CAZIP CODE:
90746
CAPACITY: 14TOTAL ENROLLED CHILDREN: 8CENSUS: DATE:
09/15/2026
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH: Licensee Patricia Butler TIME VISIT/
INSPECTION COMPLETED:
12:45 PM
NARRATIVE
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Licensing Program Analyst (LPA) Ashley Calderon and Samantha Ruiz conducted an unannounced case management visit to the above facility. LPA's met with Resident Roberta Butler who informed LPA's Licensee Patricia Butler is on their way to the facility.

Upon arrival, LPA's observed construction workers and construction supplies in the front yard. LPA's asked Roberta Butler if they are caring for children at this time; R.Butler stated " No." Licensee Patricia Butler shortly arrived at the facility, who allowed entrance into the garage, that is now an ADU and informed LPA's main house is being worked on. LPA's discussed the purpose of today's visit. LPA's observed 0 children in care.

Initially LPA's arrived to observe the bodies of water -pool that is on premises; due to risk of construction on site pool is currently not available to access. LPA's will return to do a pool inspection at another time. LPA's observed active construction. Construction was reported to the Licensing Department on June 5, 2026. It was reported that home and garage was being worked on.

During today's visit per Butler in the home the following was constructed: floors of all rooms, bedroom floors and paint, kitchen counters, paint in all areas, stairs from carpet to wood and Garage is now an ADU. LPA's requested permit for the ADU, per Butler will have to email the permits and does not have them available at this time. Per Butler, construction will be done approximately by the end of this month, per Butler will keep the department informed on the completion of the construction.

This is a two story home which consists of 6 bedrooms, 3 bathrooms, kitchen, living room, family room, garage that is now converted to an ADU, front yard and backyard with a pool (fenced).

Due to construction the children are currently using the ADU only per Butler- the ADU was observed to have a kitchen / dining area, living room, 1 bedroom, and 1 bathroom. LPA's informed Licensee to cease operation of the family day care until construction in the main house is completed.
Warren Birks
Ashley Calderon
DATE: 09/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/15/2026
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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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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Document Has Been Signed on 09/15/2026 12:27 PM - It Cannot Be Edited


Created By: Ashley Calderon On 09/15/2026 at 11:47 AM
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
, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: BUTLER FAMILY DAY CARE
FACILITY NUMBER: 198006610

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/15/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/15/2026
Section Cited
CCR
102423(a)(2)

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102423 Personal Rights
(2) To receive safe, healthful, and comfortable accommodations, furnishings, and equipment.
The requirement was not met as evidenced by:
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Licensee P.Butler, will submit a plan (Declaration Form given) on ceasing operation until main house is done with construction and how they will keep children from reach and accessible to construction worker's supplies and materials. Submit plan by poc due date.
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 LPA's observed at 10:05am and 11:34am bags of Polyblend Plus Grout, 1 box of Grout, Klean Strip Acetone, RedGard Crack Prevention bottle, Woodlife Copper Coat Green Wood Preservative, and bottle of Crew - Tile and Grout Rejuvenator, construction wood and tile(s), this was observed in the front yard where children pass by to enter the facility.
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Type B
10/15/2026
Section Cited
CCR102416.3(a)(1)

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(1) Conversion of a garage (either attached or detached) into a "child care" room.
The requirement was not met as evidenced by:
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Licensee P.Butler, will submit ADU permit and updated Facility Sketch via email by poc due date.
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Licensee P.Butler stated only has 2 children at a time in the ADU, main house is not available for child care does not have ADU permit available to show LPA's. ADU has no approval from the fire department.
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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.
Warren Birks
NAME OF LICENSING PROGRAM MANAGER:
Ashley Calderon
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 09/15/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/15/2026


LIC809 (FAS) - (06/04)
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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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: BUTLER FAMILY DAY CARE
FACILITY NUMBER: 198006610
VISIT DATE: 09/15/2026
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When there is no construction the children use the family room, restroom in the hallway, one bedroom, kitchen, and the front yard . During today's visit LPA gave consultation regarding not using the garage/ADU for child care unless it is approved by the Fire Department and permits are obtained. LPA's requested Facility Sketch to be submitted.
Per Butler, reported that once the construction is done the ADU space will be for their Adult Child to reside in the ADU instead of the main house, will not be used for child care. Due to interview conducted with Licensee P.Butler who stated only has 2 children at a time in the ADU, main house is not available for child care and will submit permits for the ADU and per information obtained ADU has no Fire Department clearance for child care, deficiency was given. Per Butler, will cease operation until construction is done in the main house and does not want to go inactive at this time.

In addition, LPA's observed at 10:05am and 11:34am bags of Polyblend Plus Grout, 1 box of Grout, Klean Strip Acetone, RedGard Crack Prevention bottle, Woodlife Copper Coat Green Wood Preservative, and bottle of Crew - Tile and Grout Rejuvenator, construction wood and tile(s), this was observed in the front yard where children pass by to enter the facility, in front of the garage/ADU and pictures were taken.

Off limits to children and parents include: living room, (1) downstairs bedroom, all upstairs, 2 bathrooms, backyard (with pool) and Garage (ADU). Off limit areas are inaccessible by key lock knobs.

Per California Code of Regulation Title 22, (2) deficiencies were given on today's visit.

A notice of site visit was given to be posted for 30 days, appeal rights and an exit interview was conducted with Licensee Patricia Butler.
NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Ashley Calderon
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2026
LIC809 (FAS) - (06/04)
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