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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 192004902
Report Date: 11/21/2024
Date Signed: 11/21/2024 09:09:40 AM

Document Has Been Signed on 11/21/2024 09:09 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:GUTIERREZ FAMILY CHILD CAREFACILITY NUMBER:
192004902
ADMINISTRATOR/
DIRECTOR:		GUTIERREZ, LETICIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 262-6507
CITY:LOS ANGELESSTATE: CAZIP CODE:
90033
CAPACITY: 12TOTAL ENROLLED CHILDREN: 12CENSUS: 3DATE:
11/21/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:20 AM
MET WITH:Leticia Gutierrez, LicenseeTIME VISIT/
INSPECTION COMPLETED:
09:15 AM
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Licensing Program Analyst (LPA) Staicy Perry and Joanne Solorio Campos conducted an unannounced Case Management inspection to amend a report and citation dated 10/15/24 to add a type A deficiency in accordance with Title 22 Regulations. Please see report dated 10/15/24 LIC 9099. LPA met with Licensee, Leticia Gutierrez to whom the reason for the visit was explained. Census was taken. There were 2 staff present caring for 3 children. The facility was observed to be operating within the license capacity limitations. Report and citation from 10/15/24 was amended on this day.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with Licensee, Leticia Gutierrez.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Staicy Perry
LICENSING EVALUATOR SIGNATURE: DATE: 11/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/21/2024
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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