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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198007825
Report Date: 10/22/2019
Date Signed: 10/22/2019 08:55:00 AM

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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:ESPINOZA FAMILY CHILD CAREFACILITY NUMBER:
198007825
ADMINISTRATOR:ESPINOZA, LAMBERTAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 267-8331
CITY:LOS ANGELESSTATE: CAZIP CODE:
90023
CAPACITY:14CENSUS: 0DATE:
10/22/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:10 AM
MET WITH:LicenseeTIME COMPLETED:
09:00 AM
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Licensing Program Analyst (LPA) Tiffanie Tran arrived at the above facility to conclude a Case Management Incident inspection on a self-reported incident that occurred at Espinoza Family Child Care on 07/12/19. The facility made the 24 hours self-report on 07/18/19. The Monterey Park South West Office received the writing report on 07/18/19. Upon arrival, LPA met with licensee. LPA did not observe any child care children. All adults have fingerprinted cleared and associated to the licensed facility.

On 07/12/19, licensee left the country due to family emergency. Licensee had notified all enrolling families and also offered alternative child care arrangement. LPA reminded, when utilizing other licensed facility as a backup plan ensure to meet the proper ratio and capacity. At this time based on the available information it does not appear this incident was the result of a Title 22 violation operation of family child care home. No deficiency was found during today's inspection. However, due to the delay of reporting requirement the facility had been cited for Type B on 9/12/19 and cleared on the same day. No further follow up is required.

An exit interview was conducted, a copy of this report was provided to the director.

SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Tiffanie TranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 10/22/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2019
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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