<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 192001526
Report Date: 05/29/2026
Date Signed: 05/29/2026 11:58:22 AM

Document Has Been Signed on 05/29/2026 11:58 AM - 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:CERVANTES FAMILY CHILD CAREFACILITY NUMBER:
192001526
ADMINISTRATOR/
DIRECTOR:		CERVANTES, SILVIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 266-7233
CITY:LOS ANGELESSTATE: CAZIP CODE:
90022
CAPACITY: 14TOTAL ENROLLED CHILDREN: 4CENSUS: 0DATE:
05/29/2026
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:15 AM
MET WITH:Licensee, Silvia CervantesTIME VISIT/
INSPECTION COMPLETED:
12:15 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 5/29/2026 Licensing Program Analysts (LPA) Monica Ruiz conducted an unannounced annual random inspection of the facility noted above. LPA was greeted by Licensee, Silvia Cervantes. LPA presented identification, disclosed the purpose of the inspection to Licensee and provided LIC126- Entrance Checklist.

Licensee Cervantes states that there are currently four (4) children enrolled, no children were present during today’s inspection.
LPA Ruiz informed Licensee that any changes to the facility’s hours of operation, people providing care to day care children, or changes to the home, must be reported to Licensing immediately.

Licensee was not able to locate her original children’s roster. Licensee completed a new children’s roster during this visit. Adults in the home were discussed.

Licensee was reminded that if no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home. Per Licensee, the facility’s hours of operation are Monday – Friday, 6am – 6pm.
Emergency Disaster Plan, License, and Parents’ Rights were observed to be posted on the wall by the television, in the living room. Disaster drill log was not available during today’s inspection.

This is a single-story house with 3 bedrooms and 2 bathrooms, detached garage that remains locked at all times, laundry area with chemicals and cleaning compounds inaccessible to children in care, living room, family room, dining room, kitchen, completely fenced rear yard and front yard.
page 1
NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Monica Ruiz
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/29/2026
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 11
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)
Page: 2 of 11
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: CERVANTES FAMILY CHILD CARE
FACILITY NUMBER: 192001526
VISIT DATE: 05/29/2026
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
The day care takes place in living room, dining room, bedroom #2, hallway bathroom and rear yard. The home is clean, orderly, comfortable, and well ventilated.

LPA reminded Licensee that construction or any changes to the areas used by children must be reported to licensing.

All areas identified on the facility sketch were inspected to ensure that they are clean and orderly with ventilation and heating for the safety and comfort of the children. There is a working telephone maintained in the home.

The family room is used as the main day care area. LPA observed age-appropriate toys such as blocks, books, art supplies, and sensory toys all free of loose and sharp parts.

Licensee states that the children in care are older (school-age) and do not nap consistently. Licensee states that children may nap in bedroom #1, if needed.


Licensee states that children sometimes play outside in the backyard, when the weather permits.

LPA Ruiz observed ant spray on the kitchen counter, no children were in care.
Licensee states that her spouse was cleaning and spraying now because children are not in care and that the ant spray is kept in the garage, which remains locked with key during day care hours. Licensee’s spouse confirmed that hazardous chemicals are kept in the locked garage during day care hours.

LPA Ruiz toured the backyard and observed tricycles and a toddler size play structure, all in good condition, free of loose, sharp, or pointed parts.

Licensee was reminded that off-limit areas and rooms must remain locked or inaccessible during day care hours.

page 2

NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Monica Ruiz
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2026
LIC809 (FAS) - (06/04)
Page: 3 of 11
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: CERVANTES FAMILY CHILD CARE
FACILITY NUMBER: 192001526
VISIT DATE: 05/29/2026
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Trees, grass, shrubs, and plants are maintained. LPA observed that the front yard is fenced along the perimeter.

LPA reminded licensee that 100% supervision is always required when children are playing outside.

Licensee provides dinner for children in care. Licensee works with MAOF resource and referral agency.

Licensee states that a sick child can rest on the couch in the family room, until their parents can pick them up and that they use physical distancing to keep sick children isolated.

Per Licensee, there are no weapons or firearms in the home, and none were observed during this inspection. Licensee states there are no pools or bodies of water on the premises, and none were observed on this day.

The valve on the required 2A 10BC fire extinguisher indicates fully charged and was serviced on 1/16/2025.
Licensee was reminded that fire extinguishers are to be serviced or replaced every year. Smoke detector and carbon monoxide detectors were both tested at 10:00am and are functioning at this time.

LPA observed First Aid Kit to be mounted on the wall in the living room and was reviewed for necessary supplies.

The following were discussed:
Rooms that are off-limits need to be made inaccessible during operating hours. NO smoking, NO infant walkers, NO Johnny jumpers, NO saucer chairs, NO incline sleepers and any other item that falls into that category are permitted in the facility.

Effective January 1, 2010, licensees of family child care homes are required to ensure that at least one staff member with current training in pediatric first aid and pediatric CPR is on site at all times when children are present.
Licensee’s CPR certificate expires on 1/17/2027.

page 3
NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Monica Ruiz
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2026
LIC809 (FAS) - (06/04)
Page: 4 of 11
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: CERVANTES FAMILY CHILD CARE
FACILITY NUMBER: 192001526
VISIT DATE: 05/29/2026
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
The Licensee has current Pediatric First Aid and CPR. Proof of immunization against influenza, pertussis, and measles was unavailable during today’s inspection. Licensee has not taken Mandated Reporter Training
due to no internet access.

- CPR Card valid until: 1/17/2027
- Fire Extinguisher was purchased on: 3/2026
- Mandated Reporter AB1207 Completed:

- Children’s records and required licensing forms were discussed as well as
mandated child abuse reporting and criminal record clearance requirement.

AB 1207: Beginning on January 1, 2018, this law requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Volunteers are encouraged but not required to take the training. Website: http://www.mandatedreporterca.com/
Licensee has a valid mandated reporter certificate on file that expires on 7/8/2027.

Senate Bill 792: this bill, commencing September 1, 2016, prohibits a person from being employed or volunteering at a child care facility or family day care if he or she has not been immunized against influenza, pertussis and measles.

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.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

page 4

NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Monica Ruiz
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2026
LIC809 (FAS) - (06/04)
Page: 5 of 11
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: CERVANTES FAMILY CHILD CARE
FACILITY NUMBER: 192001526
VISIT DATE: 05/29/2026
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Licensee states that she does care for infants and does not provide overnight care.

Incidental Medical Services (IMS) policy was discussed. Licensee states that none of the children enrolled take medication.
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/.

Licensee 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.

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.

During the exit interview, Licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Licensee, Silvia Cervantes

NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Monica Ruiz
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2026
LIC809 (FAS) - (06/04)
Page: 6 of 11
Document Has Been Signed on 05/29/2026 11:58 AM - It Cannot Be Edited


Created By: Monica Ruiz On 05/29/2026 at 11:37 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: CERVANTES FAMILY CHILD CARE
FACILITY NUMBER: 192001526

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/29/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review and interview, the licensee did not comply with the section cited above in that Licensee states she has not taken the Mandated Reporter course, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/26/2026
Plan of Correction
1
2
3
4
Licensee states that her daughter in-law will help her acess the online course. License states she will take the course and send a copy of the certificate to Licesning by the POC date.
Section Cited
Deficient Practice Statement
1
2
3
4
POC Due Date:
Plan of Correction
1
2
3
4
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:
Monica Ruiz
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 05/29/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/29/2026


LIC809 (FAS) - (06/04)
Page: 7 of 11