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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198004325
Report Date: 05/01/2024
Date Signed: 05/01/2024 04:18:02 PM


Document Has Been Signed on 05/01/2024 04:18 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:ENCISO FAMILY CHILD CAREFACILITY NUMBER:
198004325
ADMINISTRATOR:ENCISO, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 369-9597
CITY:VALINDASTATE: CAZIP CODE:
91744
CAPACITY:14CENSUS: 8DATE:
05/01/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Maria EncisoTIME COMPLETED:
03:00 PM
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On 5/1/2024 at 2:00 pm, Licensing Program Analyst (LPA), Carolyn Tuba conducted an unannounced POC (plan of correction) inspection to ensure the deficiency cited on 4/26/2024 during an annual visit have been corrected. A COVID risk assessment was conducted. LPA met with Licensee, Maria Enciso. LPA observed 8 children in care with Licensee and two (2) additional adults.

During the visit LPA, tested the self-latching devise for the gate that separates the swimming pool and the back patio. LPA observed that the latch is 6 inches from the top of the gate and latches on its own.

LPA cleared the deficiency on this date and provided a copy Proof of Correction (POC) clearance letter during the visit.

At this time, the facility is in compliance with California Code of Regulations Title 22. Therefore, no deficiencies are being cited.

A notice of site visit was given to Licensee and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Licensee, Maria Enciso.

SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Carolyn TubaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 05/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/01/2024
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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