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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198014052
Report Date: 04/11/2024
Date Signed: 04/11/2024 01:13:16 PM

Document Has Been Signed on 04/11/2024 01:13 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:ORTIZ FAMILY CHILD CAREFACILITY NUMBER:
198014052
ADMINISTRATOR/
DIRECTOR:		ORTIZ, ANAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 728-8510
CITY:LOS ANGELESSTATE: CAZIP CODE:
90022
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
04/11/2024
TYPE OF VISIT:OfficeUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:00 PM
MET WITH:Ana Ortiz, LicenseeTIME VISIT/
INSPECTION COMPLETED:
01:30 PM
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On April 11, 2024, an Informal office meeting was conducted to discuss concerns the Department has regarding the above facility. Present at the meeting was Ana Ortiz, Licensee, Ana Chico, Licensing Program Manager, Monique Ayala, Licensing Program Analyst and Carolyn Tuba, Licensing Program Analyst. The call meeting was conducted in Spanish.

The following items were discussed:

Personnel Requirements
02/28/2024 Case Management Inspection, based on observation and record review there was uncleared adult (Corrine Gomezcedillo) living in the garage. This was not the first time cited. Licensee was found to have Blanca Rodriguez living in the garage without criminal record clearance.

Fingerprints and criminal record information…
02/28/2024 Case Management Inspection, based on interviews that were conducted with licensee, assistants and children it was disclosed that Martin Ortiz transports children to and from school. Martin Ortiz has a criminal record exemption with the condition to not transport.

Personnel Requirements
03/14/2024 Complaint Inspection, based on interviews with children and witnesses it was disclosed that the licensee’s uncleared adult son, Edgar Ortiz has been at the licensed facility while day care children are present.
SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Monique Jessica Ayala
LICENSING EVALUATOR SIGNATURE: DATE: 04/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/11/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: ORTIZ FAMILY CHILD CARE
FACILITY NUMBER: 198014052
VISIT DATE: 04/11/2024
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Definitions
03/14/2024 Complaint Inspection, based on interviews with children, witnesses and observation it was disclosed that the licensee lives/lived in another home that is not her licensed facility.

Operations of a Family Child Care Home
03/14/2024 Complaint Inspection, based on interviews conducted with children and witnesses the licensee is not the primary care giver for children in care.

Reporting Requirements
03/14/2024 Complaint Inspection, based on interviews conducted with children and witnesses, there has been incidents where the Sheriff’s Department has been at the facility while day care children are present. These incidents have not been reported to the department.

The Licensee understands that it is her responsibility to ensure that the health and safety of children are protected at all times, that children are supervised at all times and that the Personal Rights of children will not be violated at any time children are in care. During the meeting, LPA Ayala reminded the licensee that licensee’s husband, Martin Ortiz.

Ms. Ortiz was reminded that not living in her home is considered forfeiture of license. Since licensed, it was documented that on at least six occasions, Ms. Ortiz was either not home or arrived during the inspection. Ms. Ortiz was also reminded that in 2008, an office meeting was held to discuss unlicensed care.

The Licensee is also required to view the following videos on the Department website https://ccld.childcarevideos.org/:

- Supervising Children in Family Child Care
- Children's Personal Rights in Your Child Care

The Licensee shall submit a written statement to the Department indicating how she will apply what she learned from each video to daily operation of the day care no later than April 29, 2024.
SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Monique Jessica Ayala
LICENSING EVALUATOR SIGNATURE:

DATE: 04/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2024
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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: ORTIZ FAMILY CHILD CARE
FACILITY NUMBER: 198014052
VISIT DATE: 04/11/2024
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LPA Ayala provided the licensee with TSP information.

Licensee has also been informed that for the next two years more frequent inspections will be conducted to ensure compliance with Title 22 regulations.

The licensee is required to provide copies of this Informal meeting to parents. The licensee will provide a copy of this report to the parent/guardian of children currently enrolled by the next business day or immediately upon return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled children for the next 12 months (1 year). Licensee will obtain a signature and date from the child's parent/guardian on the Acknowledgement of Receipt of Licensing Reports (LIC 9224).The licensee will keep a record immediately upon receipt of the completed and signed LIC 9224 acknowledging receipt of this report in the child's file. Licensee was provided a copy of the LIC9224.

Licensee was advised that a copy of this report will be forwarded to the local Resource & Referral Agency.

An exit interview conducted and a copy of this report was provided to licensee, Ana Ortiz.
SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Monique Jessica Ayala
LICENSING EVALUATOR SIGNATURE:

DATE: 04/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2024
LIC809 (FAS) - (06/04)
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