198004506-7-11-2025-33-CC-MRUZ-DJGPVQ-20250711113931

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198004506
Report Date: 07/11/2025
Date Signed: 07/11/2025 11:39:47 AM

Document Has Been Signed on 07/11/2025 11:39 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:	RODRIGUEZ FAMILY CHILD CARE		FACILITY NUMBER:	198004506
ADMINISTRATOR/ DIRECTOR:	RODRIGUEZ, GLORIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 766-9248
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90006
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 9	DATE:	07/11/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:30 AM
MET WITH:	Licensee		TIME VISIT/ INSPECTION COMPLETED:	12:00 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA) Monica Ruiz conducted an unannounced annual inspection. Upon arrival LPA met with Licensee,Gloria Rodriguez, who guided analysts on a tour of the facility. There are nine children present during today's visit. Also present during this inspection, was Licensee’s Assistant (daughter). This is a one-story home which consists of 3 bedrooms, 2 bathrooms, kitchen, living room, den, back house (same address), front yard and backyard (fenced). Main care is provided in the den, 1 bedroom (Napping) and back yard. The children use the bathroom located in the den. Per Licensee, areas off limits to children and parents include: 2 bedrooms, 1 bathroom, kitchen (sliding screen and door), back house and front yard. The licensee provides food for children in care. Hours of operation are Mon-Fri., 5am - 7pm. Per Licensee, she currently has one assistant. All adults present in the home have obtained a criminal record clearance or exemption prior to working, residing or volunteering in the licensed child care home. Licensee states that there are no firearms or weapons stored in the home. All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. There is telephone service via a land line and a cellphone that is used and the stays at the facility during operation hours. There is ventilation and heating (wall unit). Children and staff files were reviewed during this inspection. All homes shall conduct fire and disaster drills at least once every six months and document the date and time of each drill. Last drill documented was conducted on 4/18/2025. Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted.

NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Monica Ruiz
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/11/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2025

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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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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: RODRIGUEZ FAMILY CHILD CARE	FACILITY NUMBER: 198004506
	VISIT DATE: 07/11/2025

NARRATIVE

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The following was observed and reviewed during this inspection:
Detergents, cleaning compounds, medications, and other items which could pose a danger to children were observed to be inaccessible to children. Poisons are locked in a cabinet in the kitchen. The restroom that children use was observed to be clean and free of hazards.

The valve on the required 2A 10BC fire extinguisher indicates fully charged and was purchased within the last year per Licensee. Smoke and carbon monoxide detectors was observed to be operable.

The home is observed to be clean and orderly. Where children less than five years old are in care, stairs are fenced or barricaded. There is a sliding glass door and screen which keeps stairs inaccessible to children. There are toys and other age appropriate material available for children.
Children nap on mats in the main care area. During inspection LPA observed a crib in the main care area and 2 cribs in the main care bedroom. LPA observed one infant, sleeping in a crib in the main care bedroom with the door closed. LPA discussed safe sleep regulations with Licensee and informed Licensee and assistant that door the bedroom must remain open at all times.
Licensee states that she and assistant check on the infants every 15 minutes. LPA advised licensee to sleep infants in the main care area where they can be continuously supervised.

Currently, children are using the back yard for outdoor play. The outdoor play area was observed to be fenced. LPA observed that the outdoor yard has toys and other materials for children to play with. LPA did not observe any objects that can pose a danger to children on the outdoor yard. There are no pools or spas, or other bodies of water. There are no pets on the premises.

The licensee and other personnel have completed training on preventive health practices including Pediatric First Aid and CPR. The licensee's and assistant's Pediatric First Aid and CPR expires on 7/2026. There are first aid supplies available.

Children’s records were reviewed, including emergency information and were observed to be complete. Infants in care did have the required infant sleeping plan. However the Licensee did not have napping logs for the infants in care. This is a potential risk to children in care.

NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Monica Ruiz
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/11/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2025

LIC809 (FAS) - (06/04)

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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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: RODRIGUEZ FAMILY CHILD CARE	FACILITY NUMBER: 198004506
	VISIT DATE: 07/11/2025

NARRATIVE

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Incidental Medical Services (IMS):
The licensee states that she will not provide IMS. Per licensee, there are no children enrolled that require IMS at this time. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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: http://www.ada.gov/childqanda.htm.

LPA advised the licensee to access forms, regulations and quarterly updates on line at: www.ccld.ca.gov.

Deficiencies being cited during this inspection is available in the attached 809D page.

The notice of site inspection must remain posted for a period of 30 days during hours of operation. Failure to maintain posting will result in a civil penalty of $100.00 dollars.

Exit interview conducted with Licensee Gloria Rodriguez. Appeal rights discussed and explained.

NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Monica Ruiz
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/11/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2025

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 07/11/2025 11:39 AM - It Cannot Be Edited

Created By: Monica Ruiz On 07/11/2025 at 11:23 AM

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: RODRIGUEZ FAMILY CHILD CARE	FACILITY NUMBER: 198004506
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/11/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

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
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in that Licensee did not take the mandated reporter training, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 08/08/2025
	Plan of Correction
1 2 3 4	Take the mandated reporter training and submit certificate to licensing.

Type B

Section Cited

CCR

102425(j)(2)(D)

Infant Safe Sleep

Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following: This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview and record review the licensee did not comply with the section cited above in 1 out 1 infant did not have a sleep log. which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 08/08/2025
	Plan of Correction
1 2 3 4	Document infant safe sleep every 15 minutes and submit at least 2 weeks of sleep logs for infant to licensing.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

	Katrina Chicote
NAME OF LICENSING PROGRAM MANAGER:

	Monica Ruiz
NAME OF LICENSING PROGRAM ANALYST:

LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/11/2025

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2025

LIC809 (FAS) - (06/04)

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