<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020447
Report Date: 07/20/2023
Date Signed: 07/20/2023 02:48:32 PM

Document Has Been Signed on 07/20/2023 02:48 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:MENDOZA FAMILY CHILD CAREFACILITY NUMBER:
198020447
ADMINISTRATOR:ROXANA MENDOZAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 928-6370
CITY:LOS ANGELESSTATE: CAZIP CODE:
90033
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 11DATE:
07/20/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
02:05 PM
MET WITH:Licensee Roxana MendozaTIME COMPLETED:
03:00 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Veronica Martinez Garza conducted an unannounced POC (plan of correction) inspection on 07/20/23 at 02:05 p.m. to ensure that the Type A deficiency cited on 07/17/23 has been cleared. LPA met with Roxana Mendoza, licensee who guided analyst on a tour of the facility. Present during this inspection was the Licensee's assistant. There were 11 children present during this inspection. The following was observed:

- The report and notice of site visit issued on 07/17/23 was posted on the entryway.
- LIC 9224 Acknowledgment of Receipt of Licensing Reports was signed and place in children's file.
- Licensee is in compliance with the limitations of her license

LPA cleared deficiency on this date and LPA issued POC clearance letter during the visit.

At this time, the licensee is in compliance with California Code of Regulations Title 22. Therefore, no deficiencies are being cited.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with Licensee, Roxana Mendoza.
SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE: DATE: 07/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/20/2023
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 1