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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191595318
Report Date: 04/10/2023
Date Signed: 04/10/2023 02:26:29 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 04/10/2023 02:26 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:RUIZ FAMILY DAY CAREFACILITY NUMBER:
191595318
ADMINISTRATOR:RUIZ, PAMELAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(909) 629-8828
CITY:POMONASTATE: CAZIP CODE:
91766
CAPACITY:14CENSUS: 1DATE:
04/10/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:50 PM
MET WITH:James Ruiz TIME COMPLETED:
02:40 PM
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Licensing Program Analyst (LPA) Judy Mora conducted an unannounced inspection on 04/10/23 at 1:50 PM for the purpose of conducting an Annual Required inspection. LPA met with James Ruiz, Licensee's husband. Licensee, Pamela Ruiz, was not present at the time of arrival, but arrived during this inspection at approximately 2:00 PM. LPA observed one child in care.

Per Licensee, there are only two children(siblings) enrolled. LPA notified Licensee that a family child care license is not required to care for children from one family.

Licensee wishes to close her license at this time.

LPA advised Licensee that the license will be closed upon return to the Monterey Park Regional Office.

Exit interview conducted with Pamela Ruiz.
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Judy MoraTELEPHONE: (323) 896-6847
LICENSING EVALUATOR SIGNATURE:
DATE: 04/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/10/2023
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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