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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198002467
Report Date: 09/29/2023
Date Signed: 09/29/2023 12:45:20 PM

Document Has Been Signed on 09/29/2023 12:45 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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:LUIS, MELINDA FAMILY DAY CAREFACILITY NUMBER:
198002467
ADMINISTRATOR:LUIS, MELINDAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 258-5330
CITY:LOS ANGELESSTATE: CAZIP CODE:
90065
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 1DATE:
09/29/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Licensee Melinda LuisTIME COMPLETED:
01:00 PM
NARRATIVE
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Licensing Program Analysts (LPAs) Veronica Martinez Garza and Kruz Long conducted an unannounced POC (plan of correction) inspection on 09/29/23 at 11:40 a.m. to ensure that the Type A deficiency cited on 09/01/23 has been cleared. LPAs met with Melinda Luis, licensee who guided analysts on a tour of the facility. There was 01 child present during this inspection. The following was observed:

- Licensee placed a fence around the fountain to make it inaccessible to children; however, it does not meet Title 22 regulations for bodies of water.

LPM Ana Chico spoke with Licensee and reviewed Title 22 regulations for bodies of water. Per Licensee, she will temporarily place rocks and is in the process of installing a fence that self-latches.

Based on the LPA’s observations and records review, the following deficiencies listed on the attached LIC 809D (deficiency page) are being cited in accordance with California Code of Regulations Title 22.

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, Melinda Luis. Appeal Rights were provided.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE: DATE: 09/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/29/2023
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 09/29/2023 12:45 PM - It Cannot Be Edited


Created By: Veronica Martinez-Garza On 09/29/2023 at 12:11 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
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: LUIS, MELINDA FAMILY DAY CARE
FACILITY NUMBER: 198002467

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/29/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/02/2023
Section Cited
CCR
102417(g)(5)

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(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to:....or by surrounding the pool with a fence.
This requirement is not met as evidenced by:
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Per Licensee, she will add temporary rocks and is in the process of installing a fence that self-latches. Licensee will consider turning the fountain into a planter until a fence is installed.
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Licensee added a fence around the fountain that does not meet Title 22 regulations for bodies of water.
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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: 09/29/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/29/2023


LIC809 (FAS) - (06/04)
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