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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197415246
Report Date: 12/10/2025
Date Signed: 12/10/2025 03:30:03 PM

Document Has Been Signed on 12/10/2025 03:30 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:MATAL-BANOS FAMILY CHILD CAREFACILITY NUMBER:
197415246
ADMINISTRATOR/
DIRECTOR:		MATAL-BANOS, ANAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 919-4771
CITY:NORTH HOLLYWOODSTATE: CAZIP CODE:
91606
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 6DATE:
12/10/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:35 AM
MET WITH:Ana Matal BanosTIME VISIT/
INSPECTION COMPLETED:
03:45 PM
NARRATIVE
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On December 10, 2025, at approximately 9:35 AM, Licensing Program Analyst (LPA) Janet Gil conducted an unannounced annual inspection. LPA met with Licensee Ana Matal Banos and explained the purpose of the inspection. Present during LPA’s visit included the licensee, spouse, assistant adult daughter, minor child and 6 enrolled children (1 infant and 5 preschoolers). The licensee is a large license and is operating within capacity limits and ratios.

Licensee owns the home, which is a 5-bedroom, 3-bathroom, multi-level house. Licensee lives in the home with her spouse, one adult child, and one minor child. All adults living and working in the home have fingerprint clearance. The facility operates Monday Through Saturday 6:30 AM to 11:00 PM.

Day Care Areas: Living Room, 1st Bedroom/Nap room, Bathroom #1, and designated front yard area.

Off Limit Areas: 2nd Bedroom, 3rd Bedroom, Master Bedroom, Backyard, Garage and all upstairs area. Off limit areas have not been made inaccessible with child Safety Gates. LPA observed open door into off limit kitchen area and unlocked back door to backyard area. LPA observed Bedroom 2 to be used as the nap room. LPA reminded licensee to submit a new application and facility sketch to add room to her license. LPA also let licensee know to put a child safety gate in the entrance of the kitchen area. A Type B deficiency has been issued on today's date, please refer to LIC 809D.

At approximately 10:30 AM, LPA toured day care areas of home with the licensee. LPA observed the home to be in repair with proper temperature and ventilation. The home is equipped with a variety of toys and materials that were observed to be in working condition. LPA observed a fully stocked accessible first aid kit located in the closet area near the kitchen. LPA did not observe any accessible cleaning supplies, poisons, and solutions in day care areas. LPA observed electrical outlets to be made inaccessible with outlet covers.

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NAME OF LICENSING PROGRAM MANAGER: Betty Bell
NAME OF LICENSING PROGRAM ANALYST: Janet Gil
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 12/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/10/2025
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 10
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)
Page: 2 of 10
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: MATAL-BANOS FAMILY CHILD CARE
FACILITY NUMBER: 197415246
VISIT DATE: 12/10/2025
NARRATIVE
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LPA observed a fireplace in the off limits dining room. The home is equipped with a fully charged fire extinguisher and multiple smoke and carbon monoxide detectors. LPA tested detector in the living room, which was observed to be working. Per licensee, all alarms throughout the home are in working condition. Licensee has one enrolled child with an inhaler. Per licensee, she provides all food for the children in care.

At approximately 10:40 AM, LPA observed the bathroom for children's use was in proper working condition. LPA observed the bathroom to include appropriate toileting equipment and sanitation products. LPA did not observe any hazardous materials to be accessible to children in the bathroom.

The entire backyard is fully enclosed. Licensee stated she does not use the backyard area. LPA observed a pool in the backyard of the home. LPA observed the second gate to the pool entrance not to be in proper repair. LPA observed an opening on the lower part of the metal fence. Per spouse, the fence opening will be getting fixed soon.

LPA informed the licensee that fencing around pool must remain in place whenever licensed care is provided. LPA took pictures of the outdoor pool area in the backyard. LPA observed fence that is at least 5 feet (60 inches). LPA observed the pool did not have an alarm that has sound upon detecting entrance into water. A Type B deficiency has been issued on today's date, please refer to LIC 809D. LPA observed home to not have a life ring with a minimum exterior of 17 inches and labeled approved by the US Coast guard. LPA observed home to not have a rescue pole with hook and minimum fixed length of 12 feet. LPA also observed a daily log that shows inspection of drowning prevention safety to not be completed. Three Type B deficiency has been issued on today's date, please refer to LIC 809D.

LPA reviewed six children's records, which were complete. The children’s files have a record of emergency identification information and required immunization. LPA reviewed staff records for the licensee, assistant, and spouse, which were incomplete. Licensee's CPR/First Aid is current and will expire 9/2027. Licensee informed LPA that spouse picks up children from school and has no CPR/First Aid certification on file. A Type B deficiency has been issued on today's date, please refer to LIC 809D. All staff have no Mandated Reporter training certification. A Type B deficiency has been issued on today's date, please refer to LIC 809D. The licensee also has required immunization available for review for self and all staff.

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NAME OF LICENSING PROGRAM MANAGER: Betty Bell
NAME OF LICENSING PROGRAM ANALYST: Janet Gil
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2025
LIC809 (FAS) - (06/04)
Page: 3 of 10
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: MATAL-BANOS FAMILY CHILD CARE
FACILITY NUMBER: 197415246
VISIT DATE: 12/10/2025
NARRATIVE
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Licensee has licensing documentation properly posted and available for review. LPA reminded licensee to keep forms in visible area for parents to see. The licensee also maintains a childcare roster that was made available for review. Emergency disaster drills are conducted at least once every six months. The last disaster drill was conducted on November 3rd, 2025. Per licensee, there are no weapons or firearms in the home.

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 athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed the 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/.
NAME OF LICENSING PROGRAM MANAGER: Betty Bell
NAME OF LICENSING PROGRAM ANALYST: Janet Gil
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2025
LIC809 (FAS) - (06/04)
Page: 4 of 10
Document Has Been Signed on 12/10/2025 03:30 PM - It Cannot Be Edited


Created By: Janet Gil On 12/10/2025 at 01:13 PM
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
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: MATAL-BANOS FAMILY CHILD CARE
FACILITY NUMBER: 197415246

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/10/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.814(a)(1)(B)(ii)(I)
Pool Safety
(ii) (I) An alarm that, when placed in a swimming pool, will sound upon detecting an entrance into the water. The alarm shall be turned on and be in working condition during a facility’s operating hours while the swimming pool is not in use.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation the licensee did not comply with the section cited above in having a ASTM F2208 pool alram or a pool cover which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/24/2025
Plan of Correction
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Licensee ordered a pool alarm today during the inspection and sated she would install it once recieved. Licensee will send LPA Gil proof of working alarm.
Type B
Section Cited
HSC
1596.814(a)(2)(A)
Pool Safety
(a) A licensed family daycare home operated at a private single-family dwelling with an in-ground swimming pool on the premises shall comply with all of the following requirements: (2) The licensee shall have the following safety equipment visible from the swimming pool and readily available for immediate use: (A) A life ring with a minimum exterior diameter of 17 inches and labeled as approved by the United States Coast Guard.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on which observation, LPA observed licednsee does not have a life ring accessible in pool area with a minimum exterior diameter of 17 inches and labeled as approved by the United States Coast Guard poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/24/2025
Plan of Correction
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Licensee ordered an online life ring for her pool during the inspection. Licensee will send LPA Gil proof of correct life ring once recievd.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Betty Bell
NAME OF LICENSING PROGRAM MANAGER:
Janet Gil
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 12/10/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/10/2025


LIC809 (FAS) - (06/04)
Page: 5 of 10
Document Has Been Signed on 12/10/2025 03:30 PM - It Cannot Be Edited


Created By: Janet Gil On 12/10/2025 at 01:13 PM
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
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: MATAL-BANOS FAMILY CHILD CARE
FACILITY NUMBER: 197415246

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/10/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.814(a)(2)(B)
Pool Safety
(a) A licensed family daycare home operated at a private single-family dwelling with an in-ground swimming pool on the premises shall comply with all of the following requirements: (2) The licensee shall have the following safety equipment visible from the swimming pool and readily available for immediate use: (B) A rescue pole with a body hook and a minimum fixed length of 12 feet.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in have a correct rescue pole with a body hook for the pool area, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/24/2025
Plan of Correction
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Licensee ordered proper body hook today. Licensee will send LPA Gil proof og hook once recievd.
Type B
Section Cited
HSC
1596.814(a)(3)
Pool Safety
(a) A licensed family daycare home operated at a private single-family dwelling with an in-ground swimming pool on the premises shall comply with all of the following requirements: (3) A licensee shall perform a daily inspection of the drowning prevention safety features and safety equipment before opening the facility and maintain a log of the inspections to be provided to the department upon request.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and record review, the licensee did not comply with the section cited above in documenting daily inspection logs of the pool which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/24/2025
Plan of Correction
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Licensee stated she plans to document inspection logs on pool area and send proof to LPA Gil.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Betty Bell
NAME OF LICENSING PROGRAM MANAGER:
Janet Gil
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 12/10/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/10/2025


LIC809 (FAS) - (06/04)
Page: 6 of 10
Document Has Been Signed on 12/10/2025 03:30 PM - It Cannot Be Edited


Created By: Janet Gil On 12/10/2025 at 01:13 PM
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
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: MATAL-BANOS FAMILY CHILD CARE
FACILITY NUMBER: 197415246

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/10/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(j)(1)
Infant Safe Sleep
The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall physically check on the infant every 15 minutes.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and record review LPA Gil observe licensee was not conducting sleep logs for present infant which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/24/2025
Plan of Correction
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Licensee plans to begin to document sleep logs and send proog to LPA Gil.
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in having all staff have Mandated Reporter certificates which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/24/2025
Plan of Correction
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Licensee plans to have all adults working with children complete the training and send proof to LPA Gil.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Betty Bell
NAME OF LICENSING PROGRAM MANAGER:
Janet Gil
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 12/10/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/10/2025


LIC809 (FAS) - (06/04)
Page: 7 of 10
Document Has Been Signed on 12/10/2025 03:30 PM - It Cannot Be Edited


Created By: Janet Gil On 12/10/2025 at 01:13 PM
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
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: MATAL-BANOS FAMILY CHILD CARE
FACILITY NUMBER: 197415246

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/10/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416(c)
Personnel Requirements
(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, and record review the licensee's spouse picks up children from school and brings them to the home day care which poses a potential health, safety or personal rights risk to persons in care. Spouse does not have any CPR/First Aid certification.
POC Due Date: 12/24/2025
Plan of Correction
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Licensee stated she would sign her spouse up for training and submit proof to LPA Gil. Licensee stated she would have adult assitant daughter with CPR/First aid go with her spouse to pick up children, while he recieved certification.
Section Cited
Deficient Practice Statement
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3
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POC Due Date:
Plan of Correction
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3
4
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Betty Bell
NAME OF LICENSING PROGRAM MANAGER:
Janet Gil
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 12/10/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/10/2025


LIC809 (FAS) - (06/04)
Page: 8 of 10
Document Has Been Signed on 12/10/2025 03:30 PM - It Cannot Be Edited


Created By: Janet Gil On 12/10/2025 at 02:01 PM
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
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: MATAL-BANOS FAMILY CHILD CARE
FACILITY NUMBER: 197415246

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/10/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416.3(a)
Alterations to Existing Building or Grounds
(a) Prior to making alterations or additions to a family child care home or grounds, the licensee shall notify the Department of the proposed changed, including, but not limited to, the following:

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, observation and interview, the licensee did not comply with the section cited above in having an off limt bedroom accesible to children which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/24/2025
Plan of Correction
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Licensee plans to submit an updated application and a new facility sketch to the department.
Section Cited
Deficient Practice Statement
1
2
3
4
POC Due Date:
Plan of Correction
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2
3
4
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Betty Bell
NAME OF LICENSING PROGRAM MANAGER:
Janet Gil
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 12/10/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/10/2025


LIC809 (FAS) - (06/04)
Page: 9 of 10
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: MATAL-BANOS FAMILY CHILD CARE
FACILITY NUMBER: 197415246
VISIT DATE: 12/10/2025
NARRATIVE
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Continued, Page 4...

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

On this date, 12/9/2025, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

During the exit interview, the licensee, Ana Matal Banos, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

Seven Type B deficiency has been issued on today's date, please refer to LIC 809D.

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 the licensee, Ana Matal Banos.
NAME OF LICENSING PROGRAM MANAGER: Betty Bell
NAME OF LICENSING PROGRAM ANALYST: Janet Gil
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2025
LIC809 (FAS) - (06/04)
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