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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019786
Report Date: 04/13/2021
Date Signed: 04/13/2021 04:00:51 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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:SANDOVAL FAMILY CHILD CAREFACILITY NUMBER:
198019786
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 8DATE:
04/13/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Janet Sandoval, LicenseeTIME COMPLETED:
02:30 PM
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On April 13, 2021 at 1:00 PM, Licensing Program Analyst (LPA) Susann Sanchez conducted an announced case management (CM) tele-inspection via Facetime with Licensee, Janet Sandoval. The purpose of the tele-inspection is due to a pending application for a capacity change and to make sure operations are not occurring in "off limit" locations of the home.

During inspection LPA observed seven children, one infant and two staff members. This FCCH is under the COVID19 Blanket wavier. The Licensee is requesting an increase in capacity from 8 to 14 children. The Department received a Fire Clearance that was denied for a capacity of 14 children. Corrections given by the Long Beach Fire Department (LBFD) were not met in a timely matter. Therefore at this time care can only be provided on "limit" areas of the home. Corrections was a pull fire alarm and permits for the back studio. Per Licensee, corrections will be submitted to LBFD no later then May 14, 2021.

Once corrections are made and a fire clearance is granted, another CM will need to be conducted by the department. Licensee plans care for children in the back studio. The back studio consist of two stories, the top story has a different address and is currently occupied by a family member. There is a gate at the bottom of the stairs to prevent children going downstairs. Per Licensee children are always supervised when they are in the backyard.

Exit interview was conducted with Janet Sandoval via Facetime due to COVID19 pandemic. This report along with a copy of the appeal rights will be sent to the Licensee via email with a read receipt or confirmation of receipt of email, which will act as the Licensee signature.

SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Susann SanchezTELEPHONE: (323) 981-3366
LICENSING EVALUATOR SIGNATURE:

DATE: 04/13/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2021
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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