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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019775
Report Date: 05/20/2021
Date Signed: 05/20/2021 09:22:01 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:VELEZ FAMILY CHILD CAREFACILITY NUMBER:
198019775
ADMINISTRATOR:LETICIA JANET VELEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 688-9979
CITY:BELLFLOWERSTATE: CAZIP CODE:
90706
CAPACITY:14CENSUS: 7DATE:
05/20/2021
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
08:35 AM
MET WITH:Leticia Janet VelezTIME COMPLETED:
09:11 AM
NARRATIVE
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Licensing Program Analyst (LPA) Alicia Mooberry conducted a case management inspection. Due to COVID-19 and precautionary measures, this inspection was conducted via teleconference. LPA met with Leticia Janet Velez who provided tour of the facility. There were 7 children present.

The purpose of this inspection was to deliver amended report from previous inspection.

During the course of an inspection it was discovered through corroborating witness interviews conducted and documents that children enrolled at Velez Family Day Care were in fact receiving care and supervision at the Martinez Family Day Care Facility #198019773 (a Small Family Child Care Home) located in the rear of the same property/lot. This is a violation of the terms of license as stated in Title 22 Regulation 102352 (f)(1): "Family Child Care" means regularly provided care, protection and supervision of children, in the care giver's own home". This poses a potential risk to the health and safety of children in care.

Based on this information, the following deficiency listed on the attached LIC 809D is being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.

Exit interview was conducted with Leticia Janet Velez, Licensee. Appeal Rights were discussed and provided. was sent to licensee via email with a return receipt request in lieu of signature.

SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Alicia MooberryTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 05/20/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2021
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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: VELEZ FAMILY CHILD CARE
FACILITY NUMBER: 198019775
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/20/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/20/2021
Section Cited

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102352(f) (1) "Family Day Care" or "Family Child Care" means regularly provided care, protection and supervision of children, in the care giver's own home



This requirement is not met as evidenced by:
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Based on witness interviews conducted and documents collected and reviewed by LPA, it was determined that licensee failed to ensure children enrolled in Velez daycare were cared for and supervised at licensee's own home. This poses 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: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Alicia MooberryTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 05/20/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/20/2021
LIC809 (FAS) - (06/04)
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