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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198003557
Report Date: 10/15/2019
Date Signed: 10/15/2019 12:17:20 PM

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:RODRIGUEZ FAMILY CHILD CAREFACILITY NUMBER:
198003557
ADMINISTRATOR:RODRIGUEZ, INGRIDFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 802-6015
CITY:GLENDALESTATE: CAZIP CODE:
91202
CAPACITY:14CENSUS: 11DATE:
10/15/2019
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
11:46 AM
MET WITH:Ingrid Rodriguez, LicenseeTIME COMPLETED:
12:30 PM
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Licensing Program Analyst Anomeh Eivazian conducted an unannounced POC (Plan of Correction) inspection to ensure that the Type A and B deficiencies cited on 09/26/19 have been cleared. LPA met with Ingrid Rodriguez, licensee who guided analyst on a tour of the facility. There were 11 children present during this inspection, four being infants. Shortly after, Cassaundra Rodriguez, licensee's daughter arrived to the facility. The following have been observed:

· Staff ratio and capacity has been met. During this inspection there were 11 children in care with licensee and her assistant, Jocelyne Rodriguez.
· LPA observed licensee installed a carbon monoxide detector in the kitchen.
· Current roster of children was provided.
· LPA observed children's napping cots inside the home in the living room. Per licensee children eat either outside in the backyard or inside the home.
· LPA observed shampoos, conditioners and cleaning compounds were inaccessible to children during this inspection.
· Licensee and her assistant, Jocelyne Rodriguez completed required mandated reporter training, certificates on file.

Acknowledgement forms were observed for all children in care.

At this time, the licensee is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued today.


The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing reprehensive.
Failure to maintain posting as required will result in a civil penalty of $100.00.

LPA cleared deficiencies on this date and provided a copy of the Licensing Report to Ms. Ingried Rodriguez, Licensee, and issued POC clearance letter.
Exit interview was conducted with Licensee. Appeal rights explained & provided. A copy of this report and all other Licensing reports must be made available to the public for 3 years.
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Anomeh EivazianTELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2019
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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