197493193-3-5-2025-54-CC-CKAM-DEGTH5-20250305134409

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197493193
Report Date: 03/05/2025
Date Signed: 03/05/2025 01:44:44 PM

Document Has Been Signed on 03/05/2025 01:44 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:	BUSTOS CORTEZ FAMILY CHILD CARE		FACILITY NUMBER:	197493193
ADMINISTRATOR/ DIRECTOR:	BUSTOS CORTEZ, ALIN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 449-2335
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90018
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 0	CENSUS: 2	DATE:	03/05/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	10:40 AM
MET WITH:	Alin Bustos Cortez		TIME VISIT/ INSPECTION COMPLETED:	12:15 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	On 3/5/2025 at 10:40 AM Licensing Program Analysts (LPA) Claudia Kam conducted an Unannounced Required 1 year Annual inspection to the above facility. LPA disclosed the purpose of the inspection and met with Licensee, Alin Bustos Cortez who guided the LPA on a tour of the facility. There is 2 adult living in the home. All adults in the home were found to have criminal record clearance. Licensee states that there are currently 5 children enrolled. The children's roster was reviewed and is current. During the inspection, 2 children of preschool age, licensee and assistant were present. Licensee reports that the facility’s hours of operation are 24 hours per day, Monday thru Sunday, current hours are 6:00 am-6:00 pm Monday to Friday. Emergency Disaster Plan, License, and Parents’ Rights were posted at the time of inspection. Per Licensee, disaster drill was last conducted on February 10, 2025. This is a single-story home which consists of 3 bedrooms and 2 bathroom, kitchen, living room. Areas used by the children are the living room, bedroom 1 and hallway bathroom. Per Licensee, areas off limits to children and parents include the 2 bedrooms, master bathroom, and kitchen. LPA observed that there is a gate making the kitchen inaccessible to children in care at time of inspection, bedrooms are maintained inaccessible with a closed door. Doors were observed closed at time of inspection. All areas identified on the facility sketch as accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for the safety of the children. Main Care Area for the day care children is located upon entry to the facility in the living room and is equipped with tables for activities and meals, toy cubbies with toys for all ages, high chairs observed available. Bedroom 1 is used for play area and is equipped with a bookcase, toy kitchen, cubbies with toys for all ages, ride on toys, table and chairs for activities. LPA observed a ceiling fan in the living room and standing fan in bedroom 1 of the home. There is a working telephone maintained in the home via cell phone. Bathroom observed operable and equipped with a changing table and cubbies for diapers and change of clothes for children in care. Page 1 of 3

Denise Gibbs	TELEPHONE: (323) 981-3385
Claudia Kam	TELEPHONE: (626) 602-6842
	DATE: 03/05/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2025

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 3

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: BUSTOS CORTEZ FAMILY CHILD CARE	FACILITY NUMBER: 197493193
	VISIT DATE: 03/05/2025

NARRATIVE

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Per licensee, the children have access to an outdoor play area. LPA observed yard has adequate perimeter fencing through-out the property. LPA observed a playhouse, sand/water table, bicycles and tricycles, balls and chalk for outdoor activities. Area was observed free of loose and sharp parts available for the children in the yard. All items and yard were observed to be maintained. A pet cat and birds were observed in the home with food and water for the pet cat in the inaccessible master bedroom area.

The valve on the required 2A 10BC fire extinguisher indicates fully charged, service date reflects date of 10/2/2024. LPA checked Smoke and carbon monoxide detectors are in operable condition at time of inspection. Hazardous items including poisonous cleaning compounds were stored in the hallway storage closet and was observed locked at time of inspection. LPA observed First Aid kit kept on shelf in Main Care Area. Licensee provided proof of immunization against influenza, pertussis, and measles during today’s inspection. Licensee has current mandated reporter training and cpr.
__ Mandated Reporter valid until: 5/2025.
—CPR Card valid until: 1/2027
—Children records and required licensing forms were discussed as well as mandated child abuse reporting and criminal record clearance requirement.

Per Licensee, there are no weapons, firearms in the home and there are no bodies of water around the premises. LPA did not observe any bodies of water around the premises at time of inspection. Per licensee, they provide food for children in care. Licensee provides breakfast, lunch, dinner and am, pm snacks. Food preparation area was toured and found in compliance for safety, cleanliness, and proper storage.

LPA reviewed with licensee the LIC 311D, Forms/Records to Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. Entrance Checklist was provided to the licensee.

The following were discussed:

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home.

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SUPERVISOR'S NAME: Denise Gibbs	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Claudia Kam	TELEPHONE: (626) 602-6842
LICENSING EVALUATOR SIGNATURE:	DATE: 03/05/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2025

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: BUSTOS CORTEZ FAMILY CHILD CARE	FACILITY NUMBER: 197493193
	VISIT DATE: 03/05/2025

NARRATIVE

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A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California

During the exit interview, the Licensee, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

The facility was found in compliance per Title 22 regulations, there will be no deficiencies cited today 3/5/2025.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee Alin Bustos Cortez.

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SUPERVISOR'S NAME: Denise Gibbs	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Claudia Kam	TELEPHONE: (626) 602-6842
LICENSING EVALUATOR SIGNATURE:	DATE: 03/05/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2025

LIC809 (FAS) - (06/04)

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