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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 192007002
Report Date: 03/19/2026
Date Signed: 03/19/2026 03:22:56 PM

Document Has Been Signed on 03/19/2026 03:22 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:ZELAYA FAMILY CHILD CAREFACILITY NUMBER:
192007002
ADMINISTRATOR/
DIRECTOR:		ZELAYA, BLANCAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 778-3723
CITY:LOS ANGELESSTATE: CAZIP CODE:
90003
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 6DATE:
03/19/2026
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:00 PM
MET WITH:Blanca Zelaya, LicenseeTIME VISIT/
INSPECTION COMPLETED:
03:30 PM
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Licensing Program Analyst (LPA) Franchesca White arrived at the above facility for the purpose of an unannounced 3 year annual inspection. LPA White announced the purpose of the visit and was granted entry to the facility by Licensee Blanca Zelaya. There are 13 children enrolled, and 6 present at the time of inspection. There are 2 adults in the home and 2 out 2 have current criminal background clearance. The ages of the children served in this home are 1 to 5 years of age. The hours of operation are 7:00 a.m. to 5:00 p.m. (Monday - Friday).

The following documents were observed on the Parents Board and/or available at the time of inspection:

the License, Parents Rights, Emergency Disaster Plan, Earthquake Preparedness, Disaster Drill Log with more recent drill conducted 2/17/2026, and the facility Roster was current at the time of inspection.

All life saving devices were inspected and found to be operable at the time of inspection. The 2A 10BC full charged Fire extinguisher is located in the kitchen and has a service tag dated March 10, 2026 The smoke detector is located in the living room to the right of the entrance. The carbon monoxide detector is located in the kitchen. The isolation area for a sick child waiting to be picked up by a parent/guardian is an area of the living room not being used by the day care children. There is a working phone in the home.

This is a single-story home which consists of three bedrooms and two bathrooms, kitchen, living room, and detached garage. Main Care Areas used by the children include the living room, Bathroom 1, Bedroom 1 (used for napping), Kitchen for eating, front yard and side yard with detached garage. Per Licensee, areas off limits to children and parents include Bedroom 2, Bedroom 3, and Bathroom 2, and backyard. Per licensee, off limit areas are also locked during hours of operation, LPA observed doors to be locked.


(Report Continues 1 of 4 Pages)
NAME OF LICENSING PROGRAM MANAGER: Denise Gibbs
NAME OF LICENSING PROGRAM ANALYST: Franchesca White
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 03/19/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/19/2026
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 5
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)
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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: ZELAYA FAMILY CHILD CARE
FACILITY NUMBER: 192007002
VISIT DATE: 03/19/2026
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At 2:05, LPA White began the tour of the home with the living room space that consists of a chair, love seat, and a full couch with hardwood floors throughout the living room space and an area rug with shapes and colors for the children. There a tv stand with a flat screen tv mounted above. There is a wall heater with abrricade for the protection of the children. There is a child side activity table tot he left of the entrance of the home. Licensee states that children take the breakfast and lunch at the table. Snack is served outdoors.

At 2:15 p.m., LPA White observed the kitchen to have child safety locks on the handles of the stove, and cabinets. Licensee states that children pass through the kitchen to go outside to the play area located in the covered driveway of the home.

At 2:25 p.m., LPA White observed the bathroom to have one sink, one toilet, shower, and changing table. LPA White did not observe any slipping hazards or sharp edges. LPA White did not observe any chemicals accessible to children. There is hand washing items available to the children.

At 2:35 p.m., LPA White observed Bedroom 1 to have an air conditioning unit with cots for the 6 sleeping children. There is a mounted TV, and a crib in this room. Licensee states when it's a smaller amount of children they nap in the bedroom. When there are more children, they nap in the living room.

At 2:40 p.m, LPA White observed the outdoor activity space located in the driveway to have the following: This area is fenced by a locked gate that extends to the detached garage. This area has total shade provided by tent coverings. This side yard area that children use for day care activities to have child appropriate tables, chairs, outdoor hand washing station, black cushioning material and turf grass through out, art materials, plastic play kitchen, and other age appropriate toys free of lose and sharp parts available for children in care at time of inspection. LPA observed detached garage that children will use for more activity space to have books, child size couch, soft play toys, and other age appropriate toys free of loose sharp parts at time of inspection. LPA observed a locked gate with a sign stating off limits area to the rear backyard, making this area inaccessible to children in care.

At 2:55 p.m., LPA White observed the front yard to have the following: a gate stretching the length of the front gate to the wall in front of the house separating the play area from the driveway. Front yard is completely shaded by two well trimmed trees that cover the dramatic outdoor play areas consisting of child size couches and lounge chairs with two hand washing stations. A large slide and stepping apparatus perfectly tucked under the trees and scaffold umbrella providing more shade to the front yard. (Report Continues 2 of 4 Pages)
NAME OF LICENSING PROGRAM MANAGER: Denise Gibbs
NAME OF LICENSING PROGRAM ANALYST: Franchesca White
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/19/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2026
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: ZELAYA FAMILY CHILD CARE
FACILITY NUMBER: 192007002
VISIT DATE: 03/19/2026
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Licensee states that there are no pets in the home. LPA White did not observe any pets in the home. Licensee states that there are no bodies of water around the home. LPA White did not observe any bodies of water around the home. Licensee states that there are no guns or weapons in the home. LPA White did not observe any weapons or firearms in the home.

LPA White reviewed the 3 staff files. 3 out of 3 staff files had the required department documentation available for review at the time of inspection. Immunization records for 3 out 3 staff were available for review at the time of inspection. (Available documents noted on LIC 859)

LPA White reviewed 5 children's files. 5 out of 5 children's files had the required department documentation available for review at the time of inspection.

The following were discussed:

All areas used by children were inspected for safety, comfort, cleanliness, telephone service (cell phone), ventilation and heating (central air and heat).

Licensee Blanca Zelaya was reminded that all adults 18 and over, 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 Child Care Center. 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 Blanca Zelaya 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 Blanca Zelaya 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: (Report Continues 3 of 4 Pages)

NAME OF LICENSING PROGRAM MANAGER: Denise Gibbs
NAME OF LICENSING PROGRAM ANALYST: Franchesca White
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/19/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2026
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: ZELAYA FAMILY CHILD CARE
FACILITY NUMBER: 192007002
VISIT DATE: 03/19/2026
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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 Blanca Zelaya 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, the LICENSEE Blanca Zelaya, 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. Failure to post will result in a civil penalty of $100.

Based on today's observations, record review, and interviews there will be no deficiencies cited in accordance with California Title 22 regulations.

Exit interview conducted and report was reviewed with the licensee Blanca Zelaya. PIN 22-05-CCP Page Six

A copy of the report and appeal rights was given to Licensee Blanca Zelaya.

(Report Ends Here 4 of 4 Pages)

NAME OF LICENSING PROGRAM MANAGER: Denise Gibbs
NAME OF LICENSING PROGRAM ANALYST: Franchesca White
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/19/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2026
LIC809 (FAS) - (06/04)
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