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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 192004352
Report Date: 04/16/2024
Date Signed: 04/16/2024 11:29:26 AM

Document Has Been Signed on 04/16/2024 11:29 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:GARCIA FAMILY CHILD CAREFACILITY NUMBER:
192004352
ADMINISTRATOR/
DIRECTOR:		GARCIA, HERMELINDAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 258-1314
CITY:LOS ANGELESSTATE: CAZIP CODE:
90042
CAPACITY: 12TOTAL ENROLLED CHILDREN: 12CENSUS: 1DATE:
04/16/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:45 AM
MET WITH:Hermelinda GarciaTIME VISIT/
INSPECTION COMPLETED:
11:45 AM
NARRATIVE
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Licensing Program Analyst Veronica Martinez Garza conducted a Case Management-Deficiencies inspection on 04/16/24 at 10:45 a.m. to address 2 adults present during this inspection that do not have a fingerprint clearance. Adult #1 (A1) Efren Garcia (Licensee's son) and Adult #2 (A2) Natalie Medina (Licensee's assistant). LPA met with Licensee Hermelinda Garcia, who guided LPA on a tour of the facility. There was 01 child present.

During today’s inspection, LPA observed A1 and A2 were present during today's inspection. Per Licensee, A1 has been living in the home for approximately 8 days since he was released from the hospital. Licensee stated that her son has been staying in the off limits bedroom and does not provide care and supervision. Licensee acknowledged that her son has not obtained fingerprint clearance; however, she couldn't leave her son without a place to stay since he has nowhere to stay. LPA also observed A2 does not have fingerprint clearance. Per Licensee, A2 has been her assistant for approximately 3 weeks. Licensee stated that A2 went to get a livescan 2 weeks ago; however, licensee acknowledged that she did not receive a fingerprint clearance letter. LPA observed on Guardian that A2 fingerprint status shows "not yet submitted." A2 left the premises.

The following deficiencies were cited in accordance with Title 22 of the California Code of Regulations and Health & Safety Codes. Please see 809D for documentation of deficiencies.

Exit interview conducted and report was reviewed with the Licensee Hermelinda Garcia.

LPA Veronica MartinezGarza informed licensee Hermelinda Garcia that this report dated 04/16/24 document(s) 1 Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Veronica MartinezGarza informed the licensee Hermelinda Garcia to provide a copy of this licensing report dated 04/16/24 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE: DATE: 04/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/16/2024
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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Document Has Been Signed on 04/16/2024 11:29 AM - It Cannot Be Edited


Created By: Veronica Martinez-Garza On 04/16/2024 at 10:55 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: GARCIA FAMILY CHILD CARE
FACILITY NUMBER: 192004352

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/16/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/17/2024
Section Cited
CCR
102370(d)

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102370 Criminal Record Clearance
(d) All individuals subject to a criminal record..... prior to working, residing, or volunteering in a licensed facility:
(1) Obtain a California clearance or a criminal record exemption as required by the Department
This requirement is not met as evidenced by:
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Per Licensee, her assistant will not return until she receives a fingerprint clearance. Also, licensee stated that her son will have to stay somewhere else until he obtains a fingerprint clearance. LPA provided LIC 9163.
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LPA observed licensee's son Efren Garcia and licensee's assistant Natalie Medina do not have a fingerprint clearance.
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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.
SUPERVISOR'S NAME:Ana Chico
LICENSING EVALUATOR NAME:Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE:
DATE: 04/16/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/16/2024


LIC809 (FAS) - (06/04)
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