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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191806306
Report Date: 06/15/2026
Date Signed: 06/15/2026 12:39:51 PM

Document Has Been Signed on 06/15/2026 12:39 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:ANKA FAMILY CHILD CAREFACILITY NUMBER:
191806306
ADMINISTRATOR/
DIRECTOR:		ANKA, PHYLLISFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 663-7619
CITY:LOS ANGELESSTATE: CAZIP CODE:
90039
CAPACITY: 14TOTAL ENROLLED CHILDREN: 11CENSUS: 7DATE:
06/15/2026
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Assistant, Cynthia AnkaTIME VISIT/
INSPECTION COMPLETED:
01:15 PM
NARRATIVE
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On Monday June 14, 2026 at 9:30 a.m., Licensing Program Analysts (LPAs) J. Solorio-Campos and C. Nguyen conducted an unannounced annual inspection and met with Licensee’s assistant Cythnia Anka, whom the purpose of the visit was explained, and guided LPAs on a tour of the facility. Entrance Checklist LIC 126 was provided. Assistant states that there are 11 children enrolled. LPAs observed 7 children in care and 2 staff present. LPAs observed facility to be within ratio. Licensee stated operating hours are Monday to Friday from 8:30 a.m – 5:30 p.m.

This is a three-story house with 4 bedrooms and 4 bathrooms, an attached garage that remains locked at all times, living room, dining room, kitchen, day care (first floor), and completely fenced rear yard. Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home. Family members residing in the home were discussed (criminal record clearances on file) and names listed on form Confidential Names LIC811. The LPAs toured all areas used by children during this visit. For ill isolation, Assistant stated that the daycare’s art room is utilized. LPAs observed two entrances into the home with key pads on the doors, one of which parents utilize to come in and are provided with the code to enter.


Areas accessible to children include: day care room (located in first floor), day care art room (located in first floor), day care room’s bathroom(located in first floor), and rear yard (fenced)
Areas inaccessible to children: located in the upper floors 4 bedrooms and 3 bathrooms, the kitchen, and locked attached garage. The stairs leading to the upper floors is blocked off by a child safety gate, making it inaccessible to children.

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NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Caroline Nguyen
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/15/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 8
California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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Document is an Amendment of Original Document on 06/16/2026 08:56 AM


Created By: Caroline Nguyen On 06/15/2026 at 11:50 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: ANKA FAMILY CHILD CARE
FACILITY NUMBER: 191806306

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/15/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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.
Katrina Chicote
NAME OF LICENSING PROGRAM MANAGER:
Caroline Nguyen
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 06/15/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/15/2026


LIC809 (FAS) - (06/04)
Page: 3 of 8
Document Has Been Signed on 06/15/2026 12:39 PM - It Cannot Be Edited


Created By: Caroline Nguyen On 06/15/2026 at 11:58 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: ANKA FAMILY CHILD CARE
FACILITY NUMBER: 191806306

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/15/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416.2(b)(3)(c)


This requirement is not met as evidenced by: Unusual incident...
Deficient Practice Statement
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Based on observation, interview, and record review, the licensee did not comply with the section cited above in reporting water damage that caused flooding in the second floor and LPAs observed construction actively going on duiring operating hours which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/16/2026
Plan of Correction
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Licensee/Assistand will submit UIR form to the department within 24 hours.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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.
Katrina Chicote
NAME OF LICENSING PROGRAM MANAGER:
Caroline Nguyen
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 06/15/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/15/2026


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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: ANKA FAMILY CHILD CARE
FACILITY NUMBER: 191806306
VISIT DATE: 06/15/2026
NARRATIVE
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LPAs did not observe all the following required postings in the entry way of the facility: License, LIC 9148 Earthquake Preparedness Checklist, LIC 610A Emergency Disaster Plan, Pub 394 Notification of Parents Rights, and LIC 999 Facility sketch. Assistant stated there was a water leakage which required her to take down postings. LPAs observed Assistant post postings before the inspection ended.

LPAs inspected the facility for safety, comfort, cleanliness, ventilation and working cell phone. LPAs observed construction in the garage and inside the home on the second floor. Assistant stated there was water damage in the second floor that caused flooding and the construction may continue until the end of summer. LPAs consulted regarding Reporting Requirements CCR 102416.2 which poses potential risk(s) to the health, safety, or personal rights of children in care. For ventilation, LPAs central air and windows. LPAs observed the day care room’s furniture, manipulatives, books, soft plush toys, puzzles, art materials and other age-appropriate materials that were well maintained and free of loose, sharp, and pointed parts. There are also more age-appropriate toys, pretend play, art materials, and children’s tables/chairs in the day care room. LPAs observed napping equipment as cots and each with individual tight-fitted sheets and Assistant stated that the sheets are washed every weekend.

LPAs entered the day care room’s bathroom and observed a working toilet, working sink with hand soap. Cabinets under the sink have latches, making them inaccessible to children. LPAs reminded Assistant and personal items (ex; shampoo, toothpaste, mouthwash, or items that fall into that category) must be made inaccessible to children. LPAs observed cleaning compound items stored in a cabinet by the shower and reminded Assistant that they should be made inaccessible to children. First aid kit is available in the bathroom.

Currently, children are using the rear backyard for outdoor play time. The backyard’s entrance is through the day care’s sliding glass door. LPAs observed outdoor stairs and a gate at the bottom of the stairs in the back patio. The outdoor play area was observed to be fenced around the perimeter and side gates closed. LPAs observed toys, play structure, play houses, basketball court, tricycles, slides, swings, and areas with high climbing equipment are cushioned with material that may absorb a fall. All play equipment is age-appropriate and in safe condition (free of sharp, loose, or pointed parts).

LPAs asked the Assistant if there are any pets, poisons, firearms, or weapons, or bodies of water. Assistant stated they have 3 dogs and are always behind a separate fence in the back yard, making them inaccessible to children during operating hours.


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NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Caroline Nguyen
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2026
LIC809 (FAS) - (06/04)
Page: 5 of 8
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: ANKA FAMILY CHILD CARE
FACILITY NUMBER: 191806306
VISIT DATE: 06/15/2026
NARRATIVE
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Assistant stated they do not have any of the other above-mentioned and LPAs did not observe any. The Assistant was informed that if any poisons (ex; drano, rat poison or items that fall into that category), firearms and weapons are purchased, it is required to be locked with a key or combination lock and firearm and ammunition must be stored separately. Assistant stated if there are any, she will keep them locked in the garage which is always locked and inaccessible to children in care.

Assistant stated the facility provides breakfast (if needed), lunch, a.m./p.m. snack. LPAs informed Assistant any food brought from the children's homes, the container shall be labeled with the child's name and properly stored or refrigerated. Licensee stated that there are no children with severe food allergies nor on medication.

At time of inspection, LPAs observed the fire extinguisher located in the garage and the valve on the green area indicating fully charged. Per State Fire Marshall standards, fire extinguishers shall be serviced annually. LPAs observed the last emergency drill conducted on 05/06/2026. LPAs observed Assistant test the carbon monoxide detector and smoke alarm located first floor day care room and were operable.

LPAs observed Assistant’s NationalCPRFoundation First Aid/ CPR certification and expires 1/1/2028. LPAs advised that Assistant should retake the appropriate EMSA/pediatric approved certification. Assistant has proof of immunization against Pertussis, MMR, and Influenza declination. Assistant has completed the Child Abuse Mandated Reporter (AB 1207) training and expires 6/12/2028. Licensee was advised that the Pediatric First Aid/ CPR certification and mandated reporter training must be completed every 2 years, and is available at www.mandatedreporterca.com.

LPAs also reviewed children’s roster, children’s files including sleep logs and Assistant/Staff files. LPAs observed the files to be complete.



Assistant was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.
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NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Caroline Nguyen
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2026
LIC809 (FAS) - (06/04)
Page: 6 of 8
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: ANKA FAMILY CHILD CARE
FACILITY NUMBER: 191806306
VISIT DATE: 06/15/2026
NARRATIVE
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LPAs discussed the safe sleep regulations with Assistant and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPAs also informed Assistant of the importance of checking for and removing any recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

LPAs reminded Assistant that the following items are not permitted in a family child care facility: Infant Walkers, Johnny Jumpers, trampolines, Saucer Chairs, and/or any other item that fall into these categories. LPAs observed Assistant remove a saucer off the premises.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22- 02-CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514- 0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

Assistant was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

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NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Caroline Nguyen
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2026
LIC809 (FAS) - (06/04)
Page: 7 of 8
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: ANKA FAMILY CHILD CARE
FACILITY NUMBER: 191806306
VISIT DATE: 06/15/2026
NARRATIVE
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During the exit interview, Assistant confirmed that there are no Registered Sex Offenders living in the facility and LPAs completed the RSO profile in FAS.

Based on this information, the following deficiencies on the attached LIC 809D are 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.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit made by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.


Appeal Rights provided to Assistant.

Exit interview conducted and report was reviewed with the Assistant Cynthia Anka.

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NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Caroline Nguyen
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2026
LIC809 (FAS) - (06/04)
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