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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019679
Report Date: 02/01/2024
Date Signed: 02/01/2024 09:59:10 AM


Document Has Been Signed on 02/01/2024 09:59 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754



FACILITY NAME:ANDRADE FAMILY CHILD CAREFACILITY NUMBER:
198019679
ADMINISTRATOR:ESTELA ANDRADEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 421-1662
CITY:EL MONTESTATE: CAZIP CODE:
91732
CAPACITY:14CENSUS: 0DATE:
02/01/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH:Licensee Estela Andrade TIME COMPLETED:
10:15 AM
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Licensing Program Analysts (LPA’s) Roxana Lopez and Saul Valenzuela conducted an unannounced POC (plan of correction) inspection to insured that the Type A deficiency cited on 1/26/2024 have been cleared. LPA’s met with Estela Andrade, licensee who guided analysts on a tour of the facility. The following was observed:

- Licensee's not fingerprinted adult son was not observed to be in the home- per licensee, they have not taken fingerprints and will not be present in the home unless they do get fingerprinted.

- Signed LIC 9224 acknowledgment form was observed to be in 4 out 6 files. Per Licensee, they will get the other 2 forms signed.

LPA's advised the licensee how to access forms, regulations and quarterly updates on the Child Care Licensing Website at: www.ccld.ca.gov.

LPA’s cleared deficiency on this date and provided a copy of the Licensing Report to Estela Andrade, licensee. LPA’s issued POC clearance letter during the visit.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with Licensee, Estela Andrade.

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SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Roxana LopezTELEPHONE: (323) 854-5073
LICENSING EVALUATOR SIGNATURE:
DATE: 02/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/01/2024
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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