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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019425
Report Date: 08/30/2019
Date Signed: 08/30/2019 12:36:03 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:RIVERA GUERRA FAMILY CHILD CAREFACILITY NUMBER:
198019425
ADMINISTRATOR:ANA MARGARITA RIVERAGUERRAFACILITY TYPE:
850
ADDRESS:232 N. HERBERT AVE.TELEPHONE:
(323) 738-9706
CITY:LOS ANGELESSTATE: CAZIP CODE:
90063
CAPACITY:14CENSUS: 11DATE:
08/30/2019
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Ana Rivera Guerra TIME COMPLETED:
12:45 PM
NARRATIVE
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Licensing Program Analysts (LPAs) Crystal Green and Alicia Bailey conducted an unannounced case management inspection to the above facility. LPAs met with Licensee, Ana Rivera Guerra, due to licensee primary language being Spanish, Licensee Assistant, Destiny Guerra, assisted in translating. Census was taken.

The purpose of this visit was to ensure that the licensee is in compliance with Title 22 regulations. Upon arrival, LPAs observed the kitchen area accessible to the children in care, according to licensee facility sketch is an off-limit area. After licensing staff inspected the accessible off-limit area, it was observed to contain harsh cleaning supplies that was accessible in a unlocked cabinet under the sink. Licensing staff observed a wall heater located in the living room without any barricade accessible to the children. This is a potential risk to the health and safety of children in care. Please see attached LIC 809d. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.

Exit interview was conducted with Licensee and Licensee Assistant. Appeal rights and procedures were explained and provided.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site inspection by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Crystal GreenTELEPHONE: (323) 980-4930
LICENSING EVALUATOR SIGNATURE:

DATE: 08/30/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2019
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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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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: RIVERA GUERRA FAMILY CHILD CARE
FACILITY NUMBER: 198019425
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/30/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/06/2019
Section Cited

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Fireplaces and open-face heaters shall be screened to prevent access by children. The home shall contain a fire extinguisher and smoke detector device which meet standards established by the State Fire Marshal.
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This requirement was not met as evidence by after licensing staff inspected the accessible off-limit area, it was observed to contain harsh cleaning supplies that was accessible in a unlocked cabinet under the sink.This is a potential risk to the health and safety of children in care.
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Type B
09/06/2019
Section Cited

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Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children.
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This requirement was not met as evidence by licensing staff observed a wall heater located in the living room without any barricade accessible to the children. This is 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: Christina GabelmanTELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Crystal GreenTELEPHONE: (323) 980-4930
LICENSING EVALUATOR SIGNATURE:
DATE: 08/30/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/30/2019
LIC809 (FAS) - (06/04)
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