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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019530
Report Date: 08/09/2019
Date Signed: 08/09/2019 03:08:28 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:CHANG & MONTEAGUDO FAMILY CHILD CAREFACILITY NUMBER:
198019530
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 6DATE:
08/09/2019
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:David ChangTIME COMPLETED:
03:25 PM
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Licensing Program Analysts (LPAs) Ariel Cazares and Alicia Mooberry conducted an unannounced case management inspection on this date. LPAs met with Licensee David Chang and toured the facility. LPAs observed 6 children and 1 assistant in the home. The hours of operation are Monday through Friday 8-6pm.

An application for a capacity increase was submitted to the department. LPA conducted the inspection to address the capacity increase. LPAs inspected the home which consists of 3 bedrooms and 2 1/2 bathrooms. All areas of the home are accessible to the daycare with the exception of 1 bedroom and 1 bathroom. The outdoor areas are kept off-limits. There is an aquarium in the home that is made inaccessible to children. Per Licensee, there are no firearms. There are no bodies of water, pools, spas, etc. on the property. LPAs did not observe any hazards or violations during this inspection. All adults living and working in the home have criminal record clearance. Copy of Capacity Requirements diagram was provided at this inspection.

Per licensee, the fire department has scheduled their inspection for next week. The facility may be granted a license for a Large Family Child Care Home pending fire clearance.

No deficiencies were observed or cited on this date. Exit interview was conducted with Licensee David Chang. A copy of this report was provided.

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.
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Ariel AlmazanTELEPHONE: (323) 981-2949
LICENSING EVALUATOR SIGNATURE:

DATE: 08/09/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2019
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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