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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197493205
Report Date: 06/07/2024
Date Signed: 06/07/2024 07:21:49 PM


Document Has Been Signed on 06/07/2024 07:21 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
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245



FACILITY NAME:MONTENEGRO & CASTRO FAMILY CHILD CAREFACILITY NUMBER:
197493205
ADMINISTRATOR:MONTENEGRO, ANAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 712-0725
CITY:LAWNDALESTATE: CAZIP CODE:
90260
CAPACITY:14CENSUS: 9DATE:
06/07/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Maria Castro & Ana Montenegro - LicenseesTIME COMPLETED:
04:25 PM
NARRATIVE
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On 06/07/2024 Licensing Program Analyst (LPA) Cristina Castellanos conducted an unannounced case management inspection for the purpose of ensuring the standards are being met in accordance with California Title 22 Regulations and California Health and Safety Codes.

At approximately 9:20am LPA began the inspection and observation of the front exterior of the home. Around 9:34am LPA observed co-licensee Maria Castro enter the home and LPA identified herself and discussed the purpose of the visit. Upon entering the home, LPA observed an assistant, J. Cortez supervising children in care. LPA asked Maria Castro how many children were present in the home. Co-licensee Maria Castro responded, “10” and assistant J. Cortez responded “8.” Co-licensee proceeds to count and said, “Oh, I thought we had 10.”

LPA then toured the home both indoors and outdoors. At approximately 10:00 a.m. a 9th child was dropped off for child care. Therefore, during today’s inspection there were a total of 9 children present, along with co-licensee Maria Castro and Assistant J. Cortez providing care and supervision.

During an inspection of the home on 11/06/2023, a deficiency was cited based on assistant’s missing immunization record for regulation 1597.622 (a) (1) Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. During today’s inspection, Licensee was not able to provide immunization documents for assistant and stated that the records were in the assistant’s safe box. Based on this information, LPA requested that assistant leave the home due to missing necessary immunizations. At 11:21 a.m. assistant left the home. Between 11:21 a.m. and 11:26 a.m. the facility operated out of ratio, as co-licensee Maria Castro was present with 9 children in care. At approximately,11:26 a.m., co-licensee Ana Montenegro arrived at the home.

SUPERVISOR'S NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Cristina CastellanosTELEPHONE: 424-301-3097
LICENSING EVALUATOR SIGNATURE:
DATE: 06/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/07/2024
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 4


Document Has Been Signed on 06/07/2024 07:21 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245


FACILITY NAME: MONTENEGRO & CASTRO FAMILY CHILD CARE
FACILITY NUMBER: 197493205

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/07/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/21/2024
Section Cited
CCR
102417(a)

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Operation of a Family Child Care Home 102414(a)The licensee shall be present in the home and shall ensure...Temporary absences shall not exceed 20 percent of the hours that the facility is providing care per day.
This requirement is not met as evidenced by:
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Co-Licensee Montenegro agrees to let LPA know if she will be changing the hours of operation or quitting her day job. Declaration form LIC855 will be submitted with final resolution via email to LPA by POC due date.
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Based on observation and interview, the licensee did not comply with the section cited above, co-licensee Montenegro works for the Lawndale School District, which poses/posed a potential health, safety or personal rights risk to persons in care.
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Type B
06/21/2024
Section Cited
HSC1597.622(a)(1)

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(a)(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles...

This requirement is not met as evidenced by:
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Co-licensee agrees to provide LPA with proof of immunization record for assistant Cortez via email by POC due date. Additionally Co-licensees Montenegro and Castro agree that assistant Cortez will not returned to the facility until all immunization requested by the department is provided.
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Based on interview and record review, the licensee did not comply with the section cited above, co-licensee Castro was unable to provide assistants' proof of immunization record, which poses/posed a potential health, safety or personal rights risk to persons in care.
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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: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Cristina CastellanosTELEPHONE: 424-301-3097
LICENSING EVALUATOR SIGNATURE:
DATE: 06/07/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/07/2024
LIC809 (FAS) - (06/04)
Page: 2 of 4


Document Has Been Signed on 06/07/2024 07:21 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245


FACILITY NAME: MONTENEGRO & CASTRO FAMILY CHILD CARE
FACILITY NUMBER: 197493205

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/07/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/21/2024
Section Cited
CCR
102416.5(e)

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Staffing Ratio and Capacity 102416.5(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 is not met as evidenced by:
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Co-licensees agree to develop and implement a plan to make sure that they are compling with the capacity requirements throughout the day for a Large Family Child Care Home. Co-licensee will submit the developed plan in writing to LPA via email by the POC due date.
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Based on observation, the co-licensee did not comply with the section cited above, between 11:21am and 11:26am the facility operated out of ratio, as co-licensee Castro was present with 9 children in care, which poses/posed a potential health, safety or personal rights risk to persons in care.
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The Capacity Regulations For Family Child Care Home License was provided to Licensees.

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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: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Cristina CastellanosTELEPHONE: 424-301-3097
LICENSING EVALUATOR SIGNATURE:
DATE: 06/07/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/07/2024
LIC809 (FAS) - (06/04)
Page: 3 of 4


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: MONTENEGRO & CASTRO FAMILY CHILD CARE
FACILITY NUMBER: 197493205
VISIT DATE: 06/07/2024
NARRATIVE
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During the tour of the inside of the home, LPA inquired if co-licensee Maria Castro lived in the home and she responded, “Yes.” Upon showing LPA her bedroom, LPA observed an open luggage on top of the bed and without asking co-licensee stated, “I’m going on a trip.” LPA then asked to see co-licensee Ana Montenegro’s room. Co-licensee Maria Castro then stated that the bedroom door was locked, “my mom always locks it.” LPA then proceeded to ask co-licensee Maria Castro, “Where is Ms. Montenegro?” Co-licensee Maria Castro replied, “at work.” LPA then asked to be allowed to inspect Ana Montenegro’s room. As LPA approached Ana Montenegro’s bedroom, it was observed that the door was unlocked and opened. LPA observed that Ana Montenegro’s bedroom was vacant. Since the bedroom was empty and no bed was observed, LPA asked co-licensee Maria Castro, “Where does your mom (Ana Montenegro) sleep?” Co-licensee Maria Castro replied, “she sleeps with me.”

At approximately 11:55 a.m. LPA asked co-licensee Ana Montenegro where she works. Co-licensee Ana Montenegro replied, “I work at a school in Lawndale School District,” “I work from 7:00 a.m. – 11:00 a.m., Monday – Friday.”

There were three (3) deficiencies cited during today’s visit in accordance with the California Code of Regulations, Title 22. See LIC 9099-D(s) for additional information.



Upon receipt of this report, the Licensees shall post the Notice of Site Visit and any Licensing report documenting a Type “A” deficiency. The report and the Notice of Site Visit shall be posted for 30 consecutive days. Failure to maintain posting as required, will result in an immediate $100 civil penalty. 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 Acknowledgment of Receipt (LIC9224) form must be maintained in each child’s file immediately upon receipt from parent. Licensee was provided with a copy of the Acknowledgement of Receipt of Licensing Reports (LIC 9224) Form during this visit.

An exit interview was conducted, and Plan of Correction was reviewed and developed with the co-licensees Montenegro and Castro. A copy of this report and appeal rights were discussed and left with co-licensees Montenegro and Castro, whose signatures on this form confirm receipt of these documents.
SUPERVISOR'S NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Cristina CastellanosTELEPHONE: 424-301-3097
LICENSING EVALUATOR SIGNATURE:

DATE: 06/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2024
LIC809 (FAS) - (06/04)
Page: 4 of 4