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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019544
Report Date: 06/29/2022
Date Signed: 06/29/2022 02:53:51 PM


Document Has Been Signed on 06/29/2022 02:53 PM - It Cannot Be Edited

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:BENITEZ FAMILY CHILD CAREFACILITY NUMBER:
198019544
ADMINISTRATOR:SANDRA BENITEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 359-5551
CITY:BELL GARDENSSTATE: CAZIP CODE:
90201
CAPACITY:14CENSUS: 7DATE:
06/29/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:50 PM
MET WITH:Sandra Benitez, LicenseeTIME COMPLETED:
03:00 PM
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Visit conducted in Spanish
Licensing Program Analyst (LPA) Alicia Mooberry conducted a Case Management inspection to facility as part of the requirement of the three (3) years probation beginning on 10/07/21 based on the Stipulation and Waiver and Order dated September 28, 2021 and adopted by the Department and became effective 10/7/21.

LPA met with Sandra Benitez, Licensee, who provided tour of facility. All areas on the facility sketch including off limit areas were inspected. There were 7 napping children present including 3 infants under 24 months. Infants observed to be sleeping in separate cibs following Safe Sleep regulations. Also present was Martha Uribe, Assistant. All adult present have obtained a criminal background clearance. Individuals residing in the home were discussed and noted.


Licensee and staff files were reviewed, Licensee maintains a current facility roster. Licensee CPR/First Aid expires 09/2023. Children and staff files were reviewed and found complete. The required posting were observed in a prominent location.

Toxins and sharp items are stored in kitchen and locked bathroom cabinet inaccessible to children. Licensee was advised to frequently check the safety locks and gates as they can break with wear and tear.


Licensee maintains license and other required LIC forms posted in a visible area in the dining room.

LPA inspected the play area in the backyard. LPA discussed water safety with licensee, including providing supervision at all times while children play with water and to empty item that holds water after every use. LPA advised licensee to always ensure toys and other outdoor items are not too hot to touch for children in care.

LPA informed licensee on the following: keeping in compliance with Title 22 Regulations, criminal record clearances, mandated reporting, reporting requirements, supervision, terms of license, and record keeping.


Based on record reviews and LPA observations, no deficiencies were cited during this inspection.

Exit interview conducted with licensee Sandra Benitez.

SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Alicia MooberryTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 06/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/29/2022
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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