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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019825
Report Date: 05/31/2022
Date Signed: 05/31/2022 03:45:55 PM


Document Has Been Signed on 05/31/2022 03:45 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754



FACILITY NAME:MORENO FAMILY CHILD CAREFACILITY NUMBER:
198019825
ADMINISTRATOR:BERNANDITA A. MORENOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 403-2833
CITY:ALHAMBRASTATE: CAZIP CODE:
91803
CAPACITY:14CENSUS: 6DATE:
05/31/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Licensee, Bernandita MorenoTIME COMPLETED:
04:00 PM
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Licensing Program Analyst (LPA) Lilli Babcock conducted an unannounced POC (Plan of Correction) inspection to ensure that the Type A and Type B deficiencies cited on 5/27/2022 have been cleared. LPA met with Bernandita Moreno, Licensee who guided analyst on a tour of the facility. Also present during the inspection was licensees husband/assistant. There were 6 children, including 4 infants, present during this inspection. The following has been observed:

- LPA conducted records review of Mandated Reporter Training Certificates for licensee and her husband. Mandated Reporter Training for licensee and husband expire on 5/28/22.
- LPA reviewed sleep logs for infants
- The licensee was observed to be operating within the license capacity limitations.

At this time, the Licensee is in compliance with California Code of Regulations Title 22. Therefore, no deficiencies are being cited.

On this date, LPA cleared deficiencies from the 5/27/22 inspection and provided a copy of the Licensing Report and POC Clearance Letter to Licensee, Bernandita Moreno.

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 the licensee Bernandita Moreno.
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SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Lilli BabcockTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 05/31/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/31/2022
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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