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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198010360
Report Date: 02/19/2020
Date Signed: 02/19/2020 03:38:15 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:VELASCO & CASILLAS FAMILY CHILD CAREFACILITY NUMBER:
198010360
ADMINISTRATOR:VELASCO, A. & CASILLAS A.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 480-8156
CITY:BALDWIN PARKSTATE: CAZIP CODE:
91706
CAPACITY:14CENSUS: 12DATE:
02/19/2020
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
03:08 PM
MET WITH:Deserie Velasco, LicenseeTIME COMPLETED:
03:50 PM
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Licensing Program Analyst (LPA) Mireya Garcia conducted an unannounced POC (Plan of Correction) inspection to ensure that the Type A and Type B deficiencies cited on 11/25/2019 have been cleared. LPA met with Deserie Velasco, Licensee who guided analyst on a tour of the facility. Also present was Co-Licensee Angela Casillas. There were 12 children present during this inspection. The following has been observed:

· LPA conducted records review of Certificate of Attendance for FCC Orientation attended on 12/11/19 by both Licensee’s.
· LPA observed covered holes on the concrete floor in the front yard of the home.

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

LPA Garcia provided technical assistance to the licensee on how to access forms, regulations and quarterly updates on the Child Care Licensing Website at: www.ccld.ca.gov.

LPA cleared deficiencies on this date and provided a copy of the Licensing Report to Licensee, Deserie Velasco. LPA issued POC clearance letter during the visit.

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 representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

Exit interview was conducted with Deserie Velasco, Licensee, including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role.

Report Ends here page 1 of 1.

SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Mireya GarciaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 02/19/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/19/2020
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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