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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198016465
Report Date: 08/15/2019
Date Signed: 08/15/2019 11:08:02 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:CARDENAS FAMILY CHILD CAREFACILITY NUMBER:
198016465
ADMINISTRATOR:CARDENAS, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 569-6474
CITY:LOS ANGELESSTATE: CAZIP CODE:
90002
CAPACITY:14CENSUS: 8DATE:
08/15/2019
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
10:35 AM
MET WITH:Edwin CardenasTIME COMPLETED:
11:20 AM
NARRATIVE
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Licensing Program Analyst conducted an unannounced case management inspection on this date. LPA met with Assistant Edwin Cardenas and observed a total of 8 children with 2 additional assistants.

Upon arrival LPA observed an infant (Child #1) in a baby bouncer and was being supervised by Staff #1. LPA informed staff to remove her as baby bouncers are not permitted in the daycare. Child was immediately removed and placed in an appropriate highchair instead. Per staff, the parent brought the bouncer in. LPA reminded all staff present that baby bouncers are not permitted and the item must be removed and returned to parent.

LPA cleared deficiencies cited on 6/11/19 during an inspection. LPA reviewed the roster and the missing files for Child #1 and Child #2. Items were complete.

Deficiency for the baby bouncer is being cited on this date.

Exit interview conducted with Assistant Edwin . A copy of this report was provided and explained.

A "Notice of Site Visit" and copy of the report was issued. Notice of Site Visit must remain posted for 30 days. Failure to do so will result in a $100.00 civil penalty.
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Ariel AlmazanTELEPHONE: (323) 981-2949
LICENSING EVALUATOR SIGNATURE:

DATE: 08/15/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 2
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: CARDENAS FAMILY CHILD CARE
FACILITY NUMBER: 198016465
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/15/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/15/2019
Section Cited
CCR
102417(g)(10)
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A baby walker shall not be allowed on the premises of a family child care home in accordance with Health and Safety Code Section 1596.846(b) and (c).
This requirement has not been met as evidenced by the presence of a baby bouncer in the home. This poses a potential risk to the health and safety of children in care.
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Per Assistant Edwin Cardenas, bouncer will be returned to parent. He acknowledged bouncers are not allowed.
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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: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Ariel AlmazanTELEPHONE: (323) 981-2949
LICENSING EVALUATOR SIGNATURE:

DATE: 08/15/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2019
LIC809 (FAS) - (06/04)
Page: 2 of 2