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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 503903997
Report Date: 12/09/2021
Date Signed: 12/09/2021 05:04:36 PM

Document Has Been Signed on 12/09/2021 05:04 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, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:LOPEZ, MONICA FAMILY CHILD CAREFACILITY NUMBER:
503903997
ADMINISTRATOR:LOPEZ, MONICAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 869-3884
CITY:RIVERBANKSTATE: CAZIP CODE:
95367
CAPACITY: 14TOTAL ENROLLED CHILDREN: 12CENSUS: 1DATE:
12/09/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
04:30 PM
MET WITH:Lopez, MonicaTIME COMPLETED:
05:10 PM
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Regional Manager (RM), Rebecca Varela, Licensing Program Manager (LPM), Alice Juarez, and Licensing Program Analyst (LPA), Roman Iglesias, met with Licensee, Monica Lopez, to deliver an enhanced civil penalty of $2,000. The enhanced civil penalty is being assessed today as a result of a Personal Rights; Care and Supervision. From about January 1, 2015, through December 2019, dates not yet known to the Department, Respondent Monica Lopez failed to care and supervise Child #1, when Respondent Jesse Lopez engaged in inappropriate sexual conduct with Child #1, in violation of personal rights. Respondents Monica Lopez and Jesse Lopez engaged in conduct that is inimical to the health, morals, welfare, or safety of either an individual in or receiving services from the facility, or the people of the State of California as alleged in the paragraph above, and incorporated here by reference.

LPA Iglesias has provided Mrs. Lopez with a copy of the LIC421-D, Civil Penalty Assessment--Death/ Serious Injury/ Physical Abuse (Child Care) form and a copy of this report. Appeal rights were provided and discussed with Mrs. Lopez.

SUPERVISORS NAME: Alice Juarez
LICENSING EVALUATOR NAME: Roman Iglesias
LICENSING EVALUATOR SIGNATURE: DATE: 12/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/09/2021
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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