198010798-10-23-2025-54-CC-ACAR-DMQS5U-20251023133455

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198010798
Report Date: 10/23/2025
Date Signed: 10/23/2025 01:35:09 PM

Document Has Been Signed on 10/23/2025 01:35 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:	CARDONA FAMILY CHILD CARE		FACILITY NUMBER:	198010798
ADMINISTRATOR/ DIRECTOR:	CARDONA, VIRGINIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 316-3804
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90037
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 6	CENSUS: 2	DATE:	10/23/2025
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	11:00 AM
MET WITH:	Virginia Cardona		TIME VISIT/ INSPECTION COMPLETED:	01:15 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	****Inspection conducted in Spanish** On October 23, 2025, at 11:00 AM, Licensing Program Analyst (LPAs) A. Carter and C. Kam conducted an Unannounced 3 year required inspection and met with licensee Virginia Cardona, assistant Melecio Zarate. LPAs disclosed the purpose of the inspection and was granted entry into the facility. Licensee was provided a copy of the Facility Entrance Checklist. All adults associated to the home were found to have criminal record clearance. There were (2) daycare children and 1 adult resident present during today’s inspection. Licensee states that there are currently (6) children enrolled. Licensee reports that the facility’s hours of operation are 24 hours, Monday thru Friday. Licensee provide overnight care and transportation. Licensee left with adult resident at 11:20am, inspection continued with assistant, licensee arrived for report review and remainder of inspection at 12:30 pm. This is a single story home which consists of (3) bedrooms, (2) bathrooms. Areas accessible to children includes: Master bedroom (main care area), master bathroom, living room and dining room. Areas off limits to children and parents are: (2) hallway bedrooms, hallway bathroom, kitchen, and garage. Per licensee, off limit bedrooms and hallway bathroom are kept closed during operating hours, LPAs observed doors to be closed. LPAs observed a safety gate at the entrance of the kitchen making it inaccessible to children in care. The licensee does understand that licensing staff may have access to off-limit areas during inspection visit if necessary. All areas identified on the facility sketch as accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for the safety and comfort of the children. Report Continues Page 1 of 5**

NAME OF LICENSING PROGRAM MANAGER: Denise Gibbs
NAME OF LICENSING PROGRAM ANALYST: Andrea Carter
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/23/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2025

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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: CARDONA FAMILY CHILD CARE	FACILITY NUMBER: 198010798
	VISIT DATE: 10/23/2025

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LPAs observed required posted documentation in the living room which included:
Facility License, Publication (PUB) 394- Notification of Parent Rights and Licensing Form (LIC) 9148- Earthquake Preparedness form. LPAs observed completed facility records including: LIC 9040- Facility Roster, LIC 610- Facility Disaster Plan and Disaster drill log, last drill conducted on 06/11/25. Dual smoke/carbon monoxide detector located in the living room observed at facility at the time of inspection. LPAs did not test due to napping children. LPAs observed the 2AB10BC fire extinguisher with last service date of 10/ 07/24. Per licensee a visit will be conducted this month. LPAs advised, fire extinguishers shall be serviced or purchased new annually. Per licensee there is a working telephone and the home is ventilated by opening the windows and the home was observed to be comfortable and well-ventilated at time of inspection.

LPAs observed age appropriate toys and learning materials available for children in care, free of loose and sharp parts. The playroom had a doll house, various sizes of play kitchens, dramatic play toys, and books. The children use the bathroom inside the playroom. LPAs did not observe hazards in the bathroom. Children nap in the living room. LPAs observed 2 cribs; infant mattresses were observed to be firm with tightly fitted sheets. LPAs did not observe loose objects, bumpers, objects hanging, or objects attached to the cribs. Napping equipment does not block entrances or exits. Detergents, cleaning compounds, and medications are stored in an off-limits area of the home inaccessible to children in care. Cleaning compounds are stored in an upper kitchen cabinet above the stove. The Licensee states that poisons are locked in the garage. The Licensee was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care. The isolation area for sick children waiting to be picked is the playroom, supervised away from the other children in care. Per licensee, food is provided for children in care which includes breakfast, lunch, dinner, and 2 snacks. LPAs reminded licensee that any food brought from the children’s homes shall be labeled with child’s name and properly stored or refrigerated. There are currently no children enrolled that need medication administered.

Per licensee, the children will have access to the backyard for outside play. LPAs observed age appropriate toys for children in care. Per Licensee, children are supervised while playing outside. LPA observed yard has perimeter fencing through-out the property. Play area is free of loose and sharp articles or objects and all trees, shrubs, and plants are maintained. LPAs did not observe any pools or bodies of water on the premises.

NAME OF LICENSING PROGRAM MANAGER: Denise Gibbs
NAME OF LICENSING PROGRAM ANALYST: Andrea Carter
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/23/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2025

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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: CARDONA FAMILY CHILD CARE	FACILITY NUMBER: 198010798
	VISIT DATE: 10/23/2025

NARRATIVE

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Infant Care: Currently licensee has 1 infant under 24 months enrolled. Licensee was advised Infants shall not be swaddled in care. Car seats shall only be used for transportation purposes and shall not be used for sleeping. LPAs discussed the new Safe sleep regulation, including LIC 9227 Infant Sleep Plan for infants under 12 months, 15-minute sleep check documentation for infants 0 -24 months.

Overnight Care: LPAs discussed the following: Licensee is aware that they must remain awake while children are awake. If children sleep in separate area from licensee, the door must remain open. If licensee cannot hear children when they wake up, video or audio device can be used.

Children’s records were reviewed for (LIC) 282- Affidavit Regarding Liability Insurance, Immunization's Records, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights, and documentation of 15-minute Infant Sleep Check (0-24 months). All required licensing forms are in file.

Staff records were reviewed: Licensee and assistants’ Pediatric First Aid / CPR is valid until: 06/21/27. Staff had proof of required immunizations and TB clearance. Licensee and assistants’ Mandated Reporter training was completed on 06/21/25 and valid for 2 years.

During the inspection, children present were observed to be treated with dignity and respect, observed to be receiving safe, healthful, and comfortable accommodation, furnishings, and equipment, and free from corporal and/or unusual punishment. Per Licensee, there are no weapons or firearms in the home, there are no smokers in the home, there are no pets in the home, and there are no bodies of water around the premises. LPA did not observe any bodies of water around the premises at time of inspection.

The following were discussed:
· Rooms that are off-limits need to be made inaccessible during operating hours. NO smoking, NO infant walkers, NO Johnny jumpers, NO saucer chairs, NO incline sleepers and any other item that falls into that category are permitted in the facility.
· Effective January 1, 2010, licensees of family child care homes are required to ensure that at least one staff member with current training in Pediatric CPR / First Aid is on site at all times when children are present.

NAME OF LICENSING PROGRAM MANAGER: Denise Gibbs
NAME OF LICENSING PROGRAM ANALYST: Andrea Carter
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/23/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2025

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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: CARDONA FAMILY CHILD CARE	FACILITY NUMBER: 198010798
	VISIT DATE: 10/23/2025

NARRATIVE

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The fire extinguisher type 2A10BC must be serviced annually or as often as necessary. Smoke and carbon monoxide detectors should be checked, and batteries replaced as needed.
Reporting Requirements: Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your home. Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing.

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 at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed 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: Denise Gibbs
NAME OF LICENSING PROGRAM ANALYST: Andrea Carter
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/23/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2025

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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: CARDONA FAMILY CHILD CARE	FACILITY NUMBER: 198010798
	VISIT DATE: 10/23/2025

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Report End Page 5

Facility representative 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 Virginia Cardona, 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.

Exit interview conducted and report was reviewed with the facility representative Licensee Virginia Cardona

NAME OF LICENSING PROGRAM MANAGER: Denise Gibbs
NAME OF LICENSING PROGRAM ANALYST: Andrea Carter
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/23/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2025

LIC809 (FAS) - (06/04)

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