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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198009374
Report Date: 10/26/2021
Date Signed: 10/26/2021 12:37:36 PM

Document Has Been Signed on 10/26/2021 12:37 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:SANCHEZ FAMILY CHILD CAREFACILITY NUMBER:
198009374
ADMINISTRATOR:SANCHEZ,EDNAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 478-2780
CITY:LOS ANGELESSTATE: CAZIP CODE:
90042
CAPACITY: 14TOTAL ENROLLED CHILDREN: 12CENSUS: 9DATE:
10/26/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Edna Sanchez, Licensee TIME COMPLETED:
01:00 PM
NARRATIVE
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Licensing Program Analyst (LPA) Roxana Lopez conducted a case management inspection, following a complaint investigation on this date. Upon arrival LPA met with Assistant Katherine Sanchez- Per assistant Licensee was not home, she left at 7 to a doctors appointment.

At 8:20 am LPA observed assistant with 9 children in care. Staff to children ratios were observed not to be in accordance with Title 22 regulations. Licensee, arrived at 8:30 am and took over the inspection.

The following deficiencies listed on the attached 809D deficiencies page are being cited in accordance with California Code of Regulations Title 22

A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled children for the next 12 months (1 year). The Acknowledgement form must be maintained in each child’s file immediately upon receipt from parent. Licensee was provided with a copy of the parent

Acknowledgement of Receipt of Licensing Reports Form during this visit. A copy of the Parent Notification Requirements was also provided to the licensee.



The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

Exit interview was conducted with Licensee, Edna Sanchez. A copy of this report and appeal rights was provided.


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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Roxana Lopez
LICENSING EVALUATOR SIGNATURE: DATE: 10/26/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/26/2021
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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Document Has Been Signed on 10/26/2021 12:37 PM - It Cannot Be Edited


Created By: Roxana Lopez On 10/26/2021 at 10:04 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: SANCHEZ FAMILY CHILD CARE
FACILITY NUMBER: 198009374

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/26/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/26/2021
Section Cited
CCR
102416.5(e)

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102416.5- Staffing Ratio and Capacity (e): If no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home as specified in subsections (b) and (c). This requirement was not met as evidenced by.
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Licensee, arrived within 10 minutes to the facility- with her presence they are now in ratio. Licensee and assistant will watch videos on ratio and submit decleration.
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Based on LPA interviews and observations: Upon arrival LPA observed Assistant by herself with 9 Children. Licensee, was not home upon arrival. This poses an immediate risk for the health and safety of children.
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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.
SUPERVISOR'S NAME:Brandi VanOosten
LICENSING EVALUATOR NAME:Roxana Lopez
LICENSING EVALUATOR SIGNATURE:
DATE: 10/26/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/26/2021


LIC809 (FAS) - (06/04)
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