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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198013810
Report Date: 01/23/2025
Date Signed: 01/24/2025 08:20:43 AM

Document Has Been Signed on 01/24/2025 08:20 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:JAUREQUI FAMILY CHILD CAREFACILITY NUMBER:
198013810
ADMINISTRATOR/
DIRECTOR:		JAUREQUI, MIRNAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 964-3957
CITY:BELLFLOWERSTATE: CAZIP CODE:
90706
CAPACITY: 14TOTAL ENROLLED CHILDREN: 11CENSUS: 4DATE:
01/23/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Mirna Jaurequi, LicenseeTIME VISIT/
INSPECTION COMPLETED:
04:00 PM
NARRATIVE
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Licensing Program Analyst (LPA) Alicia Mooberry conducted an unannounced Annual - Random inspection at the above facility. Upon arrival, LPA met with the Licensee Mirna Jaurequi and informed her of the purpose for the visit. Inspection conducted in English and Spanish LPA provided the inspection Entrance Checklist (LIC 126). Licensee guided LPA on a tour of the facility. There were four children and one additional staff (S2) present during the inspection. All adults present during the inspection have obtained a criminal record clearance or exemption. Individuals residing in the home have been discussed and noted. Licensee provides care to children ages newborn to 13 years old and operation days/ hours are Monday through Friday 6:00 AM to 6:00 PM.
This is a one story home which consists of 3 bedrooms, 1.5 bathrooms, kitchen, dining room, living room, day care room (den), detached garage, front yard (fenced) and backyard (fenced). The children use the bathroom located in the kitchen area.
LPA observed an in-ground pool in the backyard of home surrounded by mesh fencing. LPA discussed with licensee AB-2866 Pool Safety, and provided technical assistance. Per licensee, they were not aware of the statute

LPA observed the following during inspection: The Access gate to pool was locked with a key, Licensee unlocked the gate and attempted open, LPA observed that the gate does not self latch posing a potential risk to the health and safety of children in care.

AB-2866 Pool Safety: 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. No alarm was installed

AB-2866: The licensee will purchase a life ring with a minimum exterior diameter of 17 inches and labeled as approved by the United States Coast Guard. will be placed visible from the swimming pool and readily available for immediate use. No Life Ring was available on this date, posing a potential risk to the health and safety of children care. --------Page 1. Report continues

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE: DATE: 01/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/23/2025
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 4
Document Has Been Signed on 01/24/2025 08:20 AM - It Cannot Be Edited


Created By: Alicia Mooberry On 01/23/2025 at 02:35 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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: JAUREQUI FAMILY CHILD CARE
FACILITY NUMBER: 198013810

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/23/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.814(a)(1)(A)(i)
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: (i) An access gate that opens away from the swimming pool and is self-closing with a self-latching, key lockable device placed no lower than 60 inches above the ground.

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 in that the access gate to the swimming pool does not self latch. LPA observed the gate to be locked with a key, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/23/2025
Plan of Correction
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Per licensee the backyard where the pool is located will not be used by children in care and the door will remaine locked by key until the pool door is fixed. Per licensee a video showing the pool gate self latching will be sent to LPA by 1/30/25
Type B
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 and interview, the licensee did not comply with the section cited above in that there is no pool alarm or cover which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/27/2025
Plan of Correction
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Per licensee the backyard where the pool is located will not be used by children in care and the door will remain locked by key until the pool alarm is installed. Per licensee, proof of purchase will be sent to LPA by 1/24/25 and proof of instalation video will be sent to LPA by POC due 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.
SUPERVISOR'S NAME:Denise Gibbs
LICENSING EVALUATOR NAME:Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:
DATE: 01/23/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/23/2025


LIC809 (FAS) - (06/04)
Page: 2 of 4
Document Has Been Signed on 01/24/2025 08:20 AM - It Cannot Be Edited


Created By: Alicia Mooberry On 01/23/2025 at 02:35 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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: JAUREQUI FAMILY CHILD CARE
FACILITY NUMBER: 198013810

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/23/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
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 above in tha there is no life ring available for use by pool area which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/27/2025
Plan of Correction
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Per licensee the backyard where the pool is located will not be used by children in care and the access pool door will remain locked by key until a life ring is visible and readily available for use. Per licensee, proof of purchase will be sent to LPA by 1/24/25 and proof of instalation will be sent to LPA by POC due date.
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
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Based on observation and interview, the licensee did not comply with the section cited above in that a pool safety inspection has not been completed not logged which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/27/2025
Plan of Correction
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Per licensee the backyard where the pool is located will not be used by children in care and the door will remain locked by key until the safety measures are put in place and a daily log is compled. Per licensee, a safety pool log will be completed and copy of log wil be sent to LPA via email by POC due 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.
SUPERVISOR'S NAME:Denise Gibbs
LICENSING EVALUATOR NAME:Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:
DATE: 01/23/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/23/2025


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: JAUREQUI FAMILY CHILD CARE
FACILITY NUMBER: 198013810
VISIT DATE: 01/23/2025
NARRATIVE
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Due to time limitations this annual inspection will continue at a later date.
Exit interview conducted with licensee Mirna Jaurequi.

A copy of this report and appeal rights were provided and explained.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.
SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:

DATE: 01/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2025
LIC809 (FAS) - (06/04)
Page: 4 of 4