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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 09:20:27 AM

Document Has Been Signed on 11/21/2024 09:20 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:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:16 AM
MET WITH:Leticia Gutierrez, Licensee TIME VISIT/
INSPECTION COMPLETED:
09:35 AM
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On November 21, 2024, an unannounced Case Management - Plan of Corrections (POC) inspection was conducted by Licensing Program Analysts (LPAs) Staicy Perry and Joanne Solorio Campos to ensure Type A deficiency was cleared. LPA Perry met with licensee Leticia Gutierrez. Census was taken and LPA Perry observed 3 children in care with 2 staff. Facility is operating in ratio for a Large Family Child Care Home.

Today, LPA’s observed and obtained declaration from licensee Leticia.

LPAs provided the facility with a "Letter of Deficiency Citations Cleared." Letter must be filed in facility for three years and upon request made accessible to the public for review.

Per Chapter 3, Division 12, Title 22 Regulations no deficiencies are observed today.

LIC9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS.
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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