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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198013351
Report Date: 05/27/2025
Date Signed: 05/28/2025 10:03:53 AM

Document Has Been Signed on 05/28/2025 10:03 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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:GALLEGOS FAMILY CHILD CAREFACILITY NUMBER:
198013351
ADMINISTRATOR/
DIRECTOR:		GALLEGOS, LORENAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 241-0647
CITY:GLENDORASTATE: CAZIP CODE:
91740
CAPACITY: 14TOTAL ENROLLED CHILDREN: 6CENSUS: 1DATE:
05/27/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:45 PM
MET WITH:Lorena GallegosTIME VISIT/
INSPECTION COMPLETED:
02:50 PM
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Licensing Program Analyst (LPA) Cynthia Reyes conducted an unannounced annual inspection in English. This inspection is to ensure the health and safety standards as required by the regulations governing childcare homes are met. LPA met with licensee Lorena Gallegos. A copy of the Entrance Checklist for Child Care homes form (LIC 126) was provided. The facility operating hours are Monday through Friday 6 AM -6 PM. Individuals residing in the home are 2 adults and 0 child.

Areas used by children were inspected as follows: Kitchen, living room, 1 bath rooms, computer room, playroom and front and back yard.

Areas off limits include All 3 Bedrooms are off limits, bathroom in master bedroom and Garage **Rooms that are off-limits need to be made inaccessible during operating hours** The Licensee does understand that licensing staff may have access to off-limit areas during inspection visit if necessary.



Licensee has the License, Parent’s Rights poster and other required forms posted in the day care room and documents are visible for all to see. LPA reviewed facility records for LIC 9040- Facility Roster and LIC 610- Facility Disaster Plan.

Cleaning supplies were observed inaccessible. The home has electrical outlet covers. and a First Aid Kit is available. There are adequate age-appropriate toys, books, and games. There are NO weapons or firearm on the premises. There are NO Swimming pool, or other bodies of water. The back yard is adequately fenced with age-appropriate toys and play equipment. A fireplace is present and is covered. .

Christina GabelmanTELEPHONE: (323) 981-3380
Cynthia ReyesTELEPHONE: (323) 981-3369
DATE: 05/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/27/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: GALLEGOS FAMILY CHILD CARE
FACILITY NUMBER: 198013351
VISIT DATE: 05/27/2025
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Licensee states that there are no poisons stored in the home and understands that all poisons must be lock, and made inaccessible to children. Isolation area for sick children waiting to be picked up is in the living room and other children will be away from the sick child in the playroom.

The following was observed and reviewed during this inspection. All areas identified on the facility sketch were inspected for safety, comfort, and cleanliness. There is telephone service via a cell phone that stays at the facility during operation hours. There is ventilation and heating. Detergents, cleaning compounds, and medications were observed to be inaccessible to children. The restroom that children use was observed to be safe and sanitary.

Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.
LPA did not observe any objects that can pose a danger to children in care. The licensee is observed to be operating within the license capacity limitations.

Children’s records were reviewed for (LIC) 282- Affidavit Regarding Liability Insurance, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights, A current children’s roster was available and reviewed with 6 children enrolled as of this date.

Licensee records were reviewed, LPA reviewed the LIC 508- Criminal Record Statement. Licensee & husband have required immunization documentation on file. Immunizations against measles and TDAP. TB clearance or risk assessment, Influenza is on file. LIC 9108- Statement Acknowledging Requirement to Report Child Abuse.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia ReyesTELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:

DATE: 05/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/27/2025
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: GALLEGOS FAMILY CHILD CARE
FACILITY NUMBER: 198013351
VISIT DATE: 05/27/2025
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LPA Reyes observed the valve on the required 2A10BC fire extinguisher indicates fully charged, tag service date is 05/20/2025. Fire extinguisher needs to be serviced yearly. Smoke detector and carbon monoxide was tested by licensee and is operable. LPA advised that all small family day care homes shall conduct fire and disaster drills at least once every 6 months and a large day care is every 3 months, and document the date and time of each drill. Last drill conducted and documented on 05/26/2025. Emergency Disaster Plan.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Criminal Record Clearance: Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Licensee was advised of the requirement to report unusual incidents and/or injuries to the parent/guardian and Licensing within the time frame specified by the regulation (within 24 hours by telephone call) and documented on the form LIC624B and submitted within 7 days by email, fax or mailed to the department. UIR Email: MPROincidentreports@dss.ca.gov

LPA advised the licensee how to access forms and regulations on line at: www.ccld.ca.gov.

Licensee completed the Mandated Reporter Training


AB1207 Mandated Child Abuse Reporting – Implementation was discussed with Licensee. Website provided: http://mandatedreporterca.com.
Report continues on next page
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia ReyesTELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:

DATE: 05/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/27/2025
LIC809 (FAS) - (06/04)
Page: 4 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: GALLEGOS FAMILY CHILD CARE
FACILITY NUMBER: 198013351
VISIT DATE: 05/27/2025
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Page 4 Facility has No transportation policy

Infant Care: LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment. Per licensee 0 infants are enrolled at this time.

Our Quarterly updates come out every 3 months they are also now in Spanish please log in to the CCLD website or you can email our advocates to have the quarterly updates send directly to your email. Child Care Advocates information: www.childcareadvocatesprogram@cdss.ca.gov

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.



Based on Licensing staff observations, interviews, and record review, there are NO Deficiencies being cited on this date in accordance with California Code of Regulations Title 22. LPA provided consultation during this inspection.

All documents keep for 3 years and keep copies of everything you mail/Email to the department.
A notice of site visit was given and must remain posted for 30 days.

The department has On Duty Workers available for questions Monday through Friday at (323) 981-3350 from 8:00 AM - 5:00 PM.

Exit interview conducted and report was reviewed with Lorena Gallegos, Licensee. During the exit interview Lorena Gallegos , Licensee, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia ReyesTELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:

DATE: 05/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/27/2025
LIC809 (FAS) - (06/04)
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