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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020462
Report Date: 06/22/2021
Date Signed: 06/22/2021 02:53:26 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:MONTIEL FAMILY CHILD CAREFACILITY NUMBER:
198020462
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 2DATE:
06/22/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:34 PM
MET WITH:Licensee, Miriam MontielTIME COMPLETED:
03:05 PM
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An unannounced Case Management Inspection was conducted today by Licensing Program Analyst (LPA) J. Guzman regarding a pending application for an increase in capacity. LPA met with Licensee Miriam Montiel who guided LPA on an indoor and outdoor tour of the facility.

The Licensee is requesting an increase in capacity from 8 to 14 children. The Licensing Department received a granted Fire Clearance for a capacity of 14 children. During today's inspection, LPA toured the facility and did not observe any deficiencies regarding today’s inspection.

Areas to be used by children: 1 bedroom, living room, dining room, one restroom in the laundry room, and the front yard for outdoor play

Areas off-limits to children: 3 bedrooms and 1 bathroom, kitchen (child safety gate located at entrance), garage (locked), and back yard.

LPA will recommend approval of the increase in capacity as the home meets Title 22 Code of Regulations and a fire clearance has been approved for a maximum capacity of 14 children.

There were no deficiencies cited during today's inspection in accordance to the California Code of Regulations Title 22, Division 12, Chapter 1

Upon receipt of this report, the Licensee shall post the Notice of Site Visit and any Licensing report documenting a type “A” deficiency. The report and the Notice of Site Visit shall be posted for 30 consecutive days. Failure to maintain posting as required, will result in an immediate $100 civil penalty.

Exit interview, copy of report was given. Appeal rights were issued and discussed.

SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Jose GuzmanTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 06/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/22/2021
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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