198016880-7-16-2026-33-CC-CNGN-DW2TWW-20260716150613

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198016880
Report Date: 07/16/2026
Date Signed: 07/16/2026 03:07:03 PM

Document Has Been Signed on 07/16/2026 03:07 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	UGALDE FAMILY CHILD CARE		FACILITY NUMBER:	198016880
ADMINISTRATOR/ DIRECTOR:	UGALDE, ANDREA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(213) 284-2888
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90057
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 11	CENSUS: 6	DATE:	07/16/2026
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:00 PM
MET WITH:	Licensee Andrea Ugalde		TIME VISIT/ INSPECTION COMPLETED:	03:30 PM

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On Thursday, July 16, 2026 at 1:00 p.m. Licensing Program Analyst (LPA) C. Nguyen conducted an unannounced annual inspection and met with licensee Andrea Ugalde, whom the purpose of the visit was explained, and guided LPA on a tour of the facility. Also present is licensee’s father, mother, and sister. Entrance Checklist LIC 126 was provided. Licensee states that there are 11 children enrolled. LPA observed 6 children. LPA observed facility to be within ratio. Licensee stated operating hours Monday to Friday from 6:00a.m-6:00pm.

This is a one-story home which consists of 3 bedrooms and 2 bathrooms, kitchen, dining room, living room and back yard(fenced). Family members residing in the home were discussed (criminal record clearances on file) and names listed on form Confidential Names LIC811. The LPA toured all areas used by children during this visit. For ill isolation, licensee stated that an area in the dining room or living room is utilized and separated from other children while they wait for parents to pick up.

Areas accessible to children include: living room, dining room, bathroom inside a bedroom, and backyard.
Areas inaccessible to children: 3 bedrooms, one bathroom and the kitchen which is blocked by the sliding door that is kept closed. Per licensee the children eat and nap in the living/dining room area.

LPA observed the following required postings in the entry way of the facility: License, LIC 9148 Earthquake Preparedness Checklist, LIC 610A Emergency Disaster Plan, Pub 394 Notification of Parents Rights, and LIC 999 Facility sketch.

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NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Caroline Nguyen
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/16/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2026

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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Document Has Been Signed on 07/16/2026 03:07 PM - It Cannot Be Edited

Created By: Caroline Nguyen On 07/16/2026 at 02:32 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: UGALDE FAMILY CHILD CARE	FACILITY NUMBER: 198016880
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/16/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview, record review, the licensee did not comply with the section cited above in 3 out of 3 staff did not have a current childcare mandated reporter training certificate available for LPA to review which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/30/2026
	Plan of Correction
1 2 3 4	Licensee will provide proof of mandated reported certification to LPA by POC due date.

Type B

Section Cited

CCR

102416(c)

Personnel Requirements

(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview, record review, the licensee did not comply with the section cited above in 2 out of 3 staff did not have a current Pediatric First Aid/CPR certificates available for LPA to review which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/30/2026
	Plan of Correction
1 2 3 4	Licensee will provide proof of pediatric first aid/CPR certification 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.

	Katrina Chicote
NAME OF LICENSING PROGRAM MANAGER:

	Caroline Nguyen
NAME OF LICENSING PROGRAM ANALYST:

LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/16/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2026

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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: UGALDE FAMILY CHILD CARE	FACILITY NUMBER: 198016880
	VISIT DATE: 07/16/2026

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LPA inspected the facility for safety, comfort, cleanliness, ventilation and working cell phone. For ventilation, LPA observed AC units/central air and ceiling fans. At 1:20 p.m., Licensee began the tour starting with the entrance of the door where parents and children enter from. LPA observed the living room furniture, manipulatives, books, toys, art materials and other age-appropriate materials that were well maintained and free of loose, sharp, and pointed parts. First aid supplies are available in the living room. In the living room, children were observed during nap time and sleeping in cots, each with individual tight-fitted sheet. Per licensee, linen are washed once a week or as soon as they are soiled. Next, LPA observed the dining room which is in an open space adjacent from the living room. The dining room had table, chairs, and a TV. There are more storage shelves which had more children toys. Per licensee the bedrooms are closed at all times.

Next, the kitchen was observed to be inaccessible with a sliding door and licensee states it is always closed during operating hours. The licensee stated that they do not provide any meals to children in care. Children bring their own food from home. LPA observed the knives and sharp objects stored in a top drawer in with the kitchen door kept closed at all times. LPA informed licensee any food brought from the children's homes, the container shall be labeled with the child's name and properly stored or refrigerated. Licensee stated that there are no children with severe food allergies nor on medication.

LPA entered the bathroom inside the bedroom and observed a working toilet, working sink with hand soap. LPA reminded licensee that personal items (ex; shampoo, toothpaste, mouthwash, or items that fall into that category) must be made inaccessible to children.

Currently, children are using the backyard for outdoor play time. The back yard entrance is through the dining room glass doors. The outdoor play area was observed to be fenced around the perimeter and side gates closed and locked. LPAs observed toys, play structure, play house, arts/crafts,, and areas with high climbing equipment are cushioned with material that may absorb a fall. All play equipment is age-appropriate and in safe condition (free of sharp, loose, or pointed parts).There is a separate garage that is locked at at all times.

LPA asked the licensee if there were any pets, poisons, firearms, or weapons, or bodies of water. Licensee stated they have 4 dogs (German Shephard, Dalmatian, Golden Retriever, Australian Kelpie), 5 indoor cats, 2 rabbits, which were observed by LPA to be locked in a crate, making them inaccessible to children. Licensee stated that the cats are usually in her parent’s bedroom. They do not have any of the other above mentioned and LPA did not observe any.

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NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Caroline Nguyen
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/16/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2026

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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: UGALDE FAMILY CHILD CARE	FACILITY NUMBER: 198016880
	VISIT DATE: 07/16/2026

NARRATIVE

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LPA observed cleaning compounds items, stored in the garage making it inaccessible for children to open. The licensee was informed that if any poisons (ex; drano, rat poison or items that fall into that category), firearms and weapons are purchased, it is required to be locked with a key or combination lock and firearm and ammunition must be stored separately. Licensee stated that there is currently a rat infestation outdoors due to a business across the street and is working with rodent control. Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.

At time of inspection, LPA observed the required 2A10BC fire extinguisher located in the front patio and back yard and the valve on the green area indicating fully charged and last purchased with receipt on 5/13/2026. Per State Fire Marshall standards, fire extinguishers shall be serviced or purchased with receipt annually. LPA informed licensee disaster drills shall be conducted every 6 months and the last emergency drill conducted on 6/15/2026. LPA observed a carbon monoxide detector and smoke alarm detectors located in the dining room and was not tested at this time due to napping children.

Licensee has proof of immunization against Pertussis, MMR, and Influenza declination. Licensee was advised that the Pediatric First Aid/ CPR certification and mandated reporter training must be completed every 2 years, and is available at www.mandatedreporterca.com.

LPA also reviewed children’s roster, children files, and staff files. LPA conducted staff file review and deemed it not complete: 3 out of 3 staff did not have a current childcare mandated reporter training certificate available for LPA to review which poses a risk to the health, safety, or personal rights of children in care. 2 out of 3 staff did not have a current Pediatric First Aid/CPR certificates available for LPA to review which poses a risk to the health, safety, or personal rights of children in care. LPA reviewed children's roster and

licensee states that it needs to be updated. Technical Violation given.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource.

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NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Caroline Nguyen
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/16/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2026

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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: UGALDE FAMILY CHILD CARE	FACILITY NUMBER: 198016880
	VISIT DATE: 07/16/2026

NARRATIVE

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LPA also informed licensee of the importance of checking for and removing any recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

LPA reminded licensee that the following items are not permitted in a family child care facility: Infant Walkers, Johnny Jumpers, trampolines, Saucer Chairs, and/or any other item that fall into these categories. Licensee reminded to follow the trampolines manufacture instructions.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22- 02-CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514- 0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

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NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Caroline Nguyen
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/16/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2026

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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: UGALDE FAMILY CHILD CARE	FACILITY NUMBER: 198016880
	VISIT DATE: 07/16/2026

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During the exit interview, licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit made by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00. Appeal Rights provided to licensee.

Based on this information, the following deficiencies on the attached LIC 809D are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.

Exit interview conducted and report was reviewed with the licensee Andrea Ugalde.

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NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Caroline Nguyen
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/16/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2026

LIC809 (FAS) - (06/04)

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