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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198009570
Report Date: 04/27/2022
Date Signed: 04/27/2022 11:17:28 AM


Document Has Been Signed on 04/27/2022 11:17 AM - 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 CENTER DR 200B
MONTEREY PARK, CA 91754



FACILITY NAME:SANCHEZ FAMILY CHILD CAREFACILITY NUMBER:
198009570
ADMINISTRATOR:SANCHEZ, ANGELICAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 421-9174
CITY:HAWAIIAN GARDENSSTATE: CAZIP CODE:
90716
CAPACITY:14CENSUS: 5DATE:
04/27/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
10:29 AM
MET WITH:Angelica Sanchez, LicenseeTIME COMPLETED:
11:20 AM
NARRATIVE
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Licensing Program Analyst (LPA), Alicia Mooberry conducted an announced Case Management Inspection in Spanish on this date. Angelica Sanchez, licensee and Karen Sanchez, Assistant were present with 5 children in care. All adult present have obtained background clearance.

During this visit the following is being cited in accordance with Title 22, California Code of Regulations:

On 4/1/22 License verbally reported that an incident that had occurred with regards to a child in care that received an injury at another daycare. Licensee stated the police visited the facility on 3/24/22. Licensee failed to report the incident in a timely manner.

Licensee was reminded to report any unusual incidents within 24 hours of occurrence and to provide a completed LIC 624B to the department within 7 days of occurrence. Licensee was provided with a copy of the LIC 624B.

Upon receipt of this report the Licensee shall post the notice of site visit. This notice shall be posted for 30 consecutive days are required. Failure to maintain posting as required will result in a $100.00 civil penalty.

Exit interview conducted, with licensee Angelica Sanchez, appeal rights explained and provided.
SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Alicia MooberryTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 04/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/27/2022
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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Document Has Been Signed on 04/27/2022 11:17 AM - 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754


FACILITY NAME: SANCHEZ FAMILY CHILD CARE
FACILITY NUMBER: 198009570

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/27/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/29/2022
Section Cited

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102416.2 Reporting Requirements: (b)The licensee shall report to the Department...(3)...(C) Any unusual incident... that threatens the physical or emotional health or safety of any child."


This requirement is not met as evidenced by:
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Based on licensee disclosure, licensee failed to report incident of child in care that received an injury at another daycare. Licensee failed to report a police visit to the facility on 3/24/22 This poses a potential risk to the health and safety of children 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: Valarie CookTELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Alicia MooberryTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 04/27/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/27/2022
LIC809 (FAS) - (06/04)
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