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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198010136
Report Date: 03/04/2022
Date Signed: 03/04/2022 12:14:44 PM

Document Has Been Signed on 03/04/2022 12:14 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:HERRERA FAMILY CHILD CAREFACILITY NUMBER:
198010136
ADMINISTRATOR:HERRERA, LIDIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 515-1522
CITY:CARSONSTATE: CAZIP CODE:
90746
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 4DATE:
03/04/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:35 AM
MET WITH:Linda Herrera, LicenseeTIME COMPLETED:
11:35 AM
NARRATIVE
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 THIS CASE MANAGEMENT INSPECTION WAS CONDUCTED IN SPANISH

Licensing Program Analyst (LPA) Susann Sanchez conducted an unannounced case management- other. Upon arrival, LPA met with Licensee Linda Herrera, who gave LPA a tour of the facility. Licensee reported to the department on 03/02/2022 that an incident occurred on 02/25/2022.

Licensee reported that on 02/25/2022, that a parent accused the Licensee of violating the child personal rights. The facility failed to report the incident.

California Code of Regulations, Title 22, Division 12, are being cited on the attached LIC 809D.



Exit interview was conducted with Licensee Linda Herrera. A copy of the appeal rights in Spanish and in English were given (LIC9058 01/16) were provided and explained.

Upon receipt, Licensee posted the Notice of Site Visit. The Notice of Site Visit shall be posted for thirty (30) consecutive days. Failure to maintain posting as required will result in a $100.00 civil penalty.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Susann Sanchez
LICENSING EVALUATOR SIGNATURE: DATE: 03/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/04/2022
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 03/04/2022 12:14 PM - It Cannot Be Edited


Created By: Susann Sanchez On 03/04/2022 at 11:52 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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: HERRERA FAMILY CHILD CARE
FACILITY NUMBER: 198010136

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/04/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/04/2022
Section Cited
CCR
102416.2(a)

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102416.2(a) Reporting Requirements (a)The licensee shall report the following information the Department by telephone or fax within the Department's next business day and during normal working hours (8am to 5pm). The requirement was not met as evidenced by: based on interviews conducted with License. Licensee admitted that she did not report
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Per Licensee understands that reporting requirements are important and stated to the LPA that she understands that all incidents that affect her facility must be reported to the department within 24 hours.
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incident in a timely matter. This poses a potential risk to the health and safety of children in care.
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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:Valarie Cook
LICENSING EVALUATOR NAME:Susann Sanchez
LICENSING EVALUATOR SIGNATURE:
DATE: 03/04/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/04/2022


LIC809 (FAS) - (06/04)
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