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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 192004154
Report Date: 01/03/2025
Date Signed: 01/03/2025 02:12:12 PM

Document Has Been Signed on 01/03/2025 02:12 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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:JACOBO FAMILY CHILD CAREFACILITY NUMBER:
192004154
ADMINISTRATOR/
DIRECTOR:		JACOBO, MARIA GONZAGAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 604-8759
CITY:COMPTONSTATE: CAZIP CODE:
90220
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
01/03/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:50 PM
MET WITH:Maria Jacobo, LicenseeTIME VISIT/
INSPECTION COMPLETED:
02:45 PM
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On 1/3/25 Licensing Program Analyst (LPA) Portia Bowden conducted an unannounced Annual Inspection at the above facility. At 12:50PM LPA met with Victoria Vizcarra, Assistant. Per Assistant Licensee is out of the home at a doctors appt. At 1PM Licensee Maria arrived, LPA provided her with an entrance check list and conducted a tour of the home. LPA observed 9 children in care, Per Licensee there are 9 children currently enrolled. Per Licensee she also operates foster care under facility number 19P055721. 3 of the children observed in care today including 1 infant are apart of her foster care. Per Licensee hours of operation are 5AM-8PM Monday- Saturday. Per licensee she provides Breakfast, AM Snack/ PM Snack, lunch and dinner. Per Licensee no outside food is permitted in the facility. Per licensee, overnight care is not provided at this time while transportation to and from school is provided. LPA observed all appropriate documents on licensing board (Facility License (LIC 203), Emergency Disaster Plan (LIC610a), Notification of Parents' Rights Poster (PUB 394), Child Care Facility Roster (LIC9040). LPA observed an emergency drill log with the date of last drill being 9/24. LPA observed Licensee current Pediatric CPR (Adult/Child/infant) and Pediatric Adult/child First Aid certifications with an expiration date of 10/26. LPA observed licensee’s current Mandated Reporter Certificate with an expiration date of 12/26. LPA observed Assistant Victoria’s Mandated Reporter Certificate with an expiration date of 11/26

Individuals residing in the home have been discussed and noted. All adults present in the home have obtained a criminal record clearance or exemption. All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. The following was observed and reviewed during this inspection:

This is a single-story home consisting of five bedrooms, three bathrooms, living room, kitchen, Den (main daycare room), dining room, enclosed backyard, front yard and detached converted garage occupied by Licensee’s ex Husband.
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Portia Bowden
LICENSING EVALUATOR SIGNATURE: DATE: 01/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/03/2025
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 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: JACOBO FAMILY CHILD CARE
FACILITY NUMBER: 192004154
VISIT DATE: 01/03/2025
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Per Licensee areas used by the children include the den (main daycare room), Dining area, one bathroom located in hallway right outside bedrooms, one bathroom located in the den, and enclosed backyard. Per Licensee areas off limits to children and parents include all five bedrooms and 1 bathroom.

Per Licensee poisons are kept in locked in an outdoor laundry room inaccessible to children in care. Per Licensee Detergents, cleaning compounds are kept in the locked laundry room inaccessible to children in care. Per licensee medication is stored in a locked offlimit bedroom inaccessible to children in care. At 1:05PM LPA observed a fully charged 2A10BC fire extinguisher on the wall of the dining room with a service tag date of 06/24. At 1:10PM LPA observed a functioning combination smoke/carbon monoxide detector on the wall in dining room. The home was observed to have proper ventilation and heating for safety and comfort. LPA observed no fireplaces on the premises. 1:15PM LPA observed one wall heater in the living room properly barricaded. The home maintains telephone service via landline cell phone. Per licensee there are no firearms on the premises.

Kitchen area was observed to be clean and free of clutter and have no sharp objects or chemical compounds accessible to children in care. At 1:15PM LPA observed kitchen knives stored in a pantry in the dining room secured by a child safety latch inaccessible to children in care. Bathroom children use located in the daycare den was observed to be clean and free of hazards. Per licensee potty training is provided.

LPA observed adequate toys and age appropriate learning materials in the daycare Den as well as cots for sleeping and one play yard. LPA observed a changing table in the dining room. Per Licensee all diapers are provided by parents. Per Licensee all sheets and blankets are washed in the facility once a week and as needed.

Outdoor Play for children in care is located in the enclosed backyard. At 1:17PM LPA observed a two level play structure with proper cushioning beneath as well as age appropriate outdoor toys, and shading.

Staff records were reviewed and observed to be complete. 3 Children’s files were reviewed, 2 out of 3 were observed to be complete. Per licensee she will obtain immunization records for 1 child and submit to LPA. A technical violation will be issued.
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Portia Bowden
LICENSING EVALUATOR SIGNATURE:

DATE: 01/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/03/2025
LIC809 (FAS) - (06/04)
Page: 3 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: JACOBO FAMILY CHILD CARE
FACILITY NUMBER: 192004154
VISIT DATE: 01/03/2025
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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, 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.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for 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.

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/.



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.

During the exit interview, Licensee Maria Jacobo, confirmed there are no Registered Sex Offenders living in the home. LPA completed the RSO profile in FAS.
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Portia Bowden
LICENSING EVALUATOR SIGNATURE:

DATE: 01/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/03/2025
LIC809 (FAS) - (06/04)
Page: 4 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: JACOBO FAMILY CHILD CARE
FACILITY NUMBER: 192004154
VISIT DATE: 01/03/2025
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No deficiencies were observed during today’s inspection. A technical violation will be issued for missing child immunization records.

Exit interview conducted with Licensee Maria Jacobo, copy of this report, and a notice of site visit were provided.

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Portia Bowden
LICENSING EVALUATOR SIGNATURE:

DATE: 01/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/03/2025
LIC809 (FAS) - (06/04)
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