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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198011508
Report Date: 07/15/2025
Date Signed: 07/16/2025 03:18:50 PM

Document Has Been Signed on 07/16/2025 03:18 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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:MUNOZ FAMILY CHILD CAREFACILITY NUMBER:
198011508
ADMINISTRATOR/
DIRECTOR:		MUNOZ, NATALIEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 485-2069
CITY:WEST COVINASTATE: CAZIP CODE:
91790
CAPACITY: 14TOTAL ENROLLED CHILDREN: 4CENSUS: 3DATE:
07/15/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:15 PM
MET WITH:Natalie Munoz- LicenseeTIME VISIT/
INSPECTION COMPLETED:
04:00 PM
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Licensing Program Analyst (LPAs) Cynthia Reyes and Youle Qi conducted an unannounced annual inspection in English. This inspection is to ensure the health and safety standards as required by the regulations governing childcare homes are met. LPA met with licensee Natalie Munoz. A copy of the Entrance Checklist for Child Care homes form (LIC 126) was provided. The facility operating hours are Monday through Friday 6 AM -6 PM. Individuals residing in the home are 5 adults and 0 child.

Areas used by children were inspected as follows: Kitchen, living room, dining room, 1st bath room, and back yard.

Areas off limits include 3 Bedrooms (1 Master), Bathroom, front yard and the Garage **Rooms that are off-limits need to be made inaccessible during operating hours** The Licensee does understand that licensing staff may have access to off-limit areas during inspection visit if necessary.



Licensee has the License, Parent’s Rights poster and other required forms posted in the kitchen, where parents pick up/drop off the children and documents are visible for all to see. LPA reviewed facility records for LIC 9040- Facility Roster and LIC 610- Facility Disaster Plan.

Cleaning supplies were observed in the kitchen locked. The home has electrical outlet covers. and a First Aid Kit is available. There are adequate age-appropriate toys, books, and games. There are NO weapons or firearm on the premises. There is a Swimming pool and no other bodies of water.

NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Cynthia Reyes
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 07/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/15/2025
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)
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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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: MUNOZ FAMILY CHILD CARE
FACILITY NUMBER: 198011508
VISIT DATE: 07/15/2025
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LPAs observe bodies of water during this visit via in-ground swimming pool. The swimming pool is surrounded by a white iron gate which is half 4.9 and 5.2 ft tall in different areas and the rest of the pool is surrounded by a brick wall and part of the day care home. The measurement from the hard concrete surface to the bottom of the fence is 2 inches, the openings between railings are less than 4.5 inches and some are as wide as 5 1/2. The swimming pool has a self- latching gate which was tested and which opens away from the swimming pool, the gate also has a lock with key 5 ft above the ground. One window in the home proides direct access to the pool. The window is located in the master bedroom with no alarms or barricades

LPAs did not observe a life ring with a minimum diameter of 17 inches, a rescue pole with a body hook and minimum fixed length of 12 feet. LPAs did not observe a pool alarm, a lockable device no lower than 60 inches above the ground, a daily inspection log to ensure pool safety. The swimming pool is not in compliance with Title 22 regulations

The back yard is adequately fenced with age-appropriate toys and play equipment. A fireplace is present and is bolted shut with an iron screen.



Licensee states that there are no poisons stored in the home and understands that all poisons must be lock, and made inaccessible to children. Isolation area for sick children waiting to be picked up is in the living room and other children will be away from the sick child in the playroom.

The following was observed and reviewed during this inspection. All areas identified on the facility sketch were inspected for safety, comfort, and cleanliness. There is telephone service via a cell phone that stays at the facility during operation hours. There is ventilation and heating. Detergents, cleaning compounds, and medications were observed to be inaccessible to children. The restroom that children use was observed to be safe and sanitary.

Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.
LPA did not observe any objects that can pose a danger to children in care. The licensee is observed to be operating within the license capacity limitations.
NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Cynthia Reyes
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2025
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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: MUNOZ FAMILY CHILD CARE
FACILITY NUMBER: 198011508
VISIT DATE: 07/15/2025
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Children’s records were reviewed for (LIC) 282- Affidavit Regarding Liability Insurance, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights, A current children’s roster was available and reviewed with "4" children enrolled as of this date.



Licensee Pediatric First Aid and CPR Exp. 09/09/2025.
Licensee records were reviewed, LPA reviewed the LIC 508- Criminal Record Statement. Licensee does not have proof of the required immunization documentation on file. Immunizations against measles and TDAP. TB clearance or risk assessment, Influenza is on file. LIC 9108- Statement Acknowledging Requirement to Report Child Abuse.

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/.

LPA Reyes observed the valve on the required 2A10BC fire extinguisher indicates fully charged, tag service date is 06/07/2025. Fire extinguisher needs to be serviced yearly. Smoke detector and carbon monoxide was tested by licensee and is operable. LPA advised that all small family day care homes shall conduct fire and disaster drills at least once every 6 months and a large day care is every 3 months, and document the date and time of each drill. Last drill conducted and documented on 06/20/2025. Emergency Disaster Plan.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Cynthia Reyes
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2025
LIC809 (FAS) - (06/04)
Page: 4 of 10
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: MUNOZ FAMILY CHILD CARE
FACILITY NUMBER: 198011508
VISIT DATE: 07/15/2025
NARRATIVE
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Criminal Record Clearance: 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.

Licensee was advised of the requirement to report unusual incidents and/or injuries to the parent/guardian and Licensing within the time frame specified by the regulation (within 24 hours by telephone call) and documented on the form LIC624B and submitted within 7 days by email, fax or mailed to the department. UIR Email: MPROincidentreports@dss.ca.gov

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

Licensee completed the Mandated Reporter Training on 07/06/2025


AB1207 Mandated Child Abuse Reporting – Implementation was discussed with Licensee. Website provided: http://mandatedreporterca.com.

Infant Care: 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-andresources/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. Per licensee 1 infants are enrolled at this time.



Our Quarterly updates come out every 3 months they are also now in Spanish please log in to the CCLD website or you can email our advocates to have the quarterly updates send directly to your email. Child Care Advocates information: www.childcareadvocatesprogram@cdss.ca.gov
NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Cynthia Reyes
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2025
LIC809 (FAS) - (06/04)
Page: 5 of 10
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: MUNOZ FAMILY CHILD CARE
FACILITY NUMBER: 198011508
VISIT DATE: 07/15/2025
NARRATIVE
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Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

Facility has a transportation policy and licensee provides food and drinks.

Based on Licensing staff observations, interviews, and record review, there are Deficiencies being cited on this date in accordance with California Code of Regulations Title 22. LPA provided consultation during this inspection.

All documents keep for 3 years and keep copies of everything you mail/Email to the department.
A notice of site visit was given and must remain posted for 30 days.

The department has On Duty Workers available for questions Monday through Friday at (323) 981-3350 from 8:00 AM - 5:00 PM.

Exit interview conducted and report was reviewed with Natalie Munoz, Licensee.



During the exit interview Natalie Munoz, Licensee, confirmed that there are No Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

LPA, Cynthia Reyes informed Licensee Natalie Munoz, that this report dated 07/15/2025 document(s) (3) Type A citation which shall be posted for 30 consecutive days as there is immediate risk to the health, safety or personal rights of a children in care. Also, LPA, Reyes informed Licensee, to provide a copy of this licensing report dated 07/15/2025 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC9224), or written statement, must be placed in the child’s file for verification.
NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Cynthia Reyes
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2025
LIC809 (FAS) - (06/04)
Page: 6 of 10
Document Has Been Signed on 07/16/2025 03:18 PM - It Cannot Be Edited


Created By: Cynthia Reyes On 07/15/2025 at 03:10 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: MUNOZ FAMILY CHILD CARE
FACILITY NUMBER: 198011508

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/15/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
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 which poses an immediate health, safety or personal rights risk to persons in care.

Licensee does not have an alarm for inside the swimming pool.
POC Due Date: 07/18/2025
Plan of Correction
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 Licensee states will purchase an alarm for inside the swimming pool and send proof by the POC date
Type A
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 observation, the licensee did not comply with the section cited abovewhich poses an immediate health, safety or personal rights risk to persons in care.

Licensee does not have the required life ring
POC Due Date: 07/18/2025
Plan of Correction
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Licensee states will purchase and submit proof by the POC date.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Christina Gabelman
NAME OF LICENSING PROGRAM MANAGER:
Cynthia Reyes
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 07/15/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/15/2025


LIC809 (FAS) - (06/04)
Page: 7 of 10
Document Has Been Signed on 07/16/2025 03:18 PM - It Cannot Be Edited


Created By: Cynthia Reyes On 07/15/2025 at 03:10 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: MUNOZ FAMILY CHILD CARE
FACILITY NUMBER: 198011508

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/15/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
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 which poses an immediate health, safety or personal rights risk to persons in care.

Licensee does not have the required life pole
POC Due Date: 07/18/2025
Plan of Correction
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Licensee states will purchase one and send proof by the POC date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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.
Christina Gabelman
NAME OF LICENSING PROGRAM MANAGER:
Cynthia Reyes
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 07/15/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/15/2025


LIC809 (FAS) - (06/04)
Page: 8 of 10
Document Has Been Signed on 07/16/2025 03:18 PM - It Cannot Be Edited


Created By: Cynthia Reyes On 07/15/2025 at 03:10 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: MUNOZ FAMILY CHILD CARE
FACILITY NUMBER: 198011508

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/15/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.814(a)(1)(A)(iv)
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: (1) The swimming pool shall be equipped with, at minimum, the following drowning prevention safety features: (A) An enclosure, including, but not limited to, a fence, wall, or other barrier that isolates the swimming pool from access to the family daycare home and has all of the following characteristics: (iv) No gaps or voids that can allow the passage of a sphere with a diameter equal to or greater than four inches.

This requirement is not met as evidenced by:
Deficient Practice Statement
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4
Based on observation, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care.

Some of the vertical bars on the swimming pool wrought iron gate are between 4 1/2 to 5 1/2 wide.
POC Due Date: 07/18/2025
Plan of Correction
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Licensee states will place a see though mesh from top to bottom on the entire gate.
Type B
Section Cited
HSC
1596.814(a)(1)(B)(ii)(II)
Pool Safety
(II) A licensee shall maintain and make available for inspection, upon request by the department, documentation that establishes the alarm is compliant with ASTM International Standard F2208.

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 which poses/posed a potential health, safety or personal rights risk to persons in care.

Licensee does not have an alarm and has not documented anything
POC Due Date: 07/18/2025
Plan of Correction
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4
Licensee will buy an alarm and start a daily log and send proof by the POC date
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Christina Gabelman
NAME OF LICENSING PROGRAM MANAGER:
Cynthia Reyes
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 07/15/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/15/2025


LIC809 (FAS) - (06/04)
Page: 9 of 10
Document Has Been Signed on 07/16/2025 03:18 PM - It Cannot Be Edited


Created By: Cynthia Reyes On 07/15/2025 at 03:10 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: MUNOZ FAMILY CHILD CARE
FACILITY NUMBER: 198011508

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/15/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
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
1
2
3
4
Based on record review, the licensee did not comply with the section cited above in which poses/posed a potential health, safety or personal rights risk to persons in care.

Licensee does not have a log
POC Due Date: 07/15/2025
Plan of Correction
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3
4
Licensee states will make a log and submit proof by the POC date.
Section Cited
Deficient Practice Statement
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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.
Christina Gabelman
NAME OF LICENSING PROGRAM MANAGER:
Cynthia Reyes
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 07/15/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/15/2025


LIC809 (FAS) - (06/04)
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