198014759-4-7-2023-12-CC-JDOY-CQNR66-20230407124413

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198014759
Report Date: 04/07/2023
Date Signed: 04/07/2023 12:45:13 PM

Document Has Been Signed on 04/07/2023 12:45 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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME:	GARCIA FAMILY CHILD CARE		FACILITY NUMBER:	198014759
ADMINISTRATOR:	GARCIA, CARLOTA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 764-4376
CITY:	SUN VALLEY	STATE: CA	ZIP CODE:	91352
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 10	DATE:	04/07/2023
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME BEGAN:	12:08 PM
MET WITH:	Carlota Garcia		TIME COMPLETED:	12:59 PM

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On 04/07/23 LPA Justin Dorsey conducted a Case Management visit at Garcia FCC for the purpose of reviewing the conditions set forth in the Stipulation and Waiver; and Order agreed on dated 03/27/23 and ordered to be effective until 03/26/25.

Licensee agrees to a two year probation of her license. The probation shall commence on 03/27/32 and shall continue through 03/26/25 which time licensee shall be granted a probationary license subject to the following terms and conditions.

The Probation conditions are as follows:

A. Respondent Carlota shall operate the facility in strict compliance with the regulations and statutes governing the operation of a family child care home.

B. During the period of probation, the Department in its sole discretion may conduct unannounced site visits for the purpose of determining whether there is full compliance with the regulations and statutes governing the operation of a family child care home.

C. Respondent Carlota shall attend an informal conference with the Palmdale Regional Office within ninety days from the effective date of this Stipulation, described below.

D. Respondent Carlota shall ensure that all individuals working, residing or volunteering in the facility shall obtain criminal record clearances or exemptions prior to their initial presence in the facility and shall maintain proof of such criminal record clearances or exemptions at the facility.

E. This Stipulation shall be posted in a conspicuous place at the facility for the duration of the probationary period.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Justin Dorsey
LICENSING EVALUATOR SIGNATURE:	DATE: 04/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/07/2023

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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: GARCIA FAMILY CHILD CARE	FACILITY NUMBER: 198014759
	VISIT DATE: 04/07/2023

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F. For the duration of the probationary period, Respondent Carlota shall inform all current and prospective parents of children in the facility of the facility's probationary license by providing to the parents a copy of this Stipulation and the attached Accusation. Parents shall sign an acknowledgment indicating they have received a copy of the Stipulation and the attached Accusation. This parental acknowledgement shall be maintained in the corresponding child's file and shall be made available to the Department upon request.

G. Within 120 days of the date of this agreement, Respondent Carlota shall complete training, education or counseling as follows: training regarding the personal rights of children. Appropriate training courses shall be identical or similar to: Behavior Management for School-Age Children course provided by Smart Horizons. Respondent Carlota may contact the Palmdale Regional Office should she have questions regarding the training, education, or counseling as described here in this Paragraph 2(G).

H. Within 2 weeks of completion of the training, education or counseling described in Paragraph 2(G), above, Respondent Carlota shall submit to the Palmdale Regional Office documentation of completion.

Licensee is informed that the term of Probation is from 03/27/2023 through 03/26/2025. Licensee was provided with a copy of the Probationary License during this visit.

Licensee shall forward copies of signed LIC9224 (Acknowledgement of Receipt) forms for the above referenced Decision and Order/Probation notification, as required per probation condition letter

Licensee Carlota Garcia was provided a current copy of the probation license to be posted, a signed copy of this report and Notice of Site Visit was provided to licensee during this inspection. During the inspection Adult #1 was present to assist with the translations between the LPA and Licensee Carlota Garcia.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Justin Dorsey
LICENSING EVALUATOR SIGNATURE:	DATE: 04/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/07/2023

LIC809 (FAS) - (06/04)

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