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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198013295
Report Date: 01/29/2025
Date Signed: 01/29/2025 10:05:04 AM

Document Has Been Signed on 01/29/2025 10:05 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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:INIGUEZ FAMILY CHILD CAREFACILITY NUMBER:
198013295
ADMINISTRATOR/
DIRECTOR:		INIGUEZ, JOSEFINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 352-4417
CITY:HUNTINGTON PARKSTATE: CAZIP CODE:
90255
CAPACITY: 10TOTAL ENROLLED CHILDREN: 10CENSUS: DATE:
01/29/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:15 AM
MET WITH:Josefina Iniguez, LicenseeTIME VISIT/
INSPECTION COMPLETED:
10:15 AM
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Licensing Program Analyst (LPA) Portia Bowden conducted an unannounced annual required inspection at the above facility on 1/29/25 at 9:15 AM. LPA met with Licensee Josefina Iniguez who guided analyst on a tour of the facility. There were no children present when LPA arrived.

Licensee stated to LPA that the facility has not had any children enrolled since August 2023. Licensee stated that they do not plan to have any children in the near future. LPA explained to the Licensee that they have an option of inactive status until they can decide of whether Licensee wishes to open her day-care. Licensee stated that they would like to place their License in inactive status at this time. LPA provided and obtained the LIC 9211 from the Licensee during inspection.

Licensee agrees to the following:
I. Will not provide child care for which a license is required until license is reactivated.
II. Will continue to promptly pay the annual license fee.
III. Will inform Licensing office of any changes in the above dates prior to re-opening facility by submitting a new LIC 9211
IV. I will be in compliance with all licensing laws and regulations upon re-opening facility, including but not limited to:
· Ensuring all adult staff and residents, including children who turn 18 during the inactive period, have criminal record clearances
· Maintaining current CPR and First Aid certifications
· Maintaining a current fire extinguisher and functioning smoke alarms

Exit interview conducted and report was reviewed with Licensee, Josefina Iniguez. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Portia Bowden
LICENSING EVALUATOR SIGNATURE: DATE: 01/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/29/2025
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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