<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198016532
Report Date: 06/25/2024
Date Signed: 06/25/2024 11:26:40 AM

Document Has Been Signed on 06/25/2024 11:26 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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:LI FAMILY CHILD CAREFACILITY NUMBER:
198016532
ADMINISTRATOR/
DIRECTOR:		LI, ANGELAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 307-1857
CITY:MONTEREY PARKSTATE: CAZIP CODE:
91755
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 12DATE:
06/25/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:45 AM
MET WITH:Licensee, Angela LiTIME VISIT/
INSPECTION COMPLETED:
11:45 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 6/25/24, Licensing Program Analysts (LPAs) Priscilla Ochoa and Kruz Long conducted an unannounced case management visit to follow up on a incident which occurred on 6/13/2014 and was reported to the department on 6/14/2024. LPAs met with licensee Angela Li and COVID-19 risk assessment was conducted. There were 12 children present with 3 staff. The incident pertains to supervision and physical environment.

During today's inspection LPAs tour the facility and interviewed staff #1 and #2.

Based on interviews with staff #1 and staff #2 there was no corroborating information to determine that there was a lack of supervision during this incident. LPAs tours the outside area where the incident occurred and did not observe any tripping hazards. The facility is not being cited any deficiencies today.

An exit interview was conducted and a copy of this report and appeals rights was provided to the licensee.

A notice of site visit was provided and must be posted for 30 days.
SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Priscilla Ochoa
LICENSING EVALUATOR SIGNATURE: DATE: 06/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/25/2024
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 1