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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198017533
Report Date: 01/11/2023
Date Signed: 01/11/2023 11:40:31 AM

Document Has Been Signed on 01/11/2023 11:40 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:HERRERA FAMILY CHILD CAREFACILITY NUMBER:
198017533
ADMINISTRATOR:HERRERA, JEANNETTEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 519-7143
CITY:MONTEBELLOSTATE: CAZIP CODE:
90640
CAPACITY: 14TOTAL ENROLLED CHILDREN: 9CENSUS: 3DATE:
01/11/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Licensee, Jeannette HerreraTIME COMPLETED:
12:00 PM
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An Unannounced Case Management Inspection was conducted by Licensing Program Analyst (LPA) Mireya García. A risk assessment was conducted prior to entering the facility. Due to COVID- 19 precautionary measures were taken, licensing staff present during inspection wore appropriate personal protective equipment. LPA met with licensee Jeannette Herrera, who guided LPA García on a tour of the entire facility indoors and outdoors. LPA’s Assistant was also present during this inspection. The purpose of today's inspection is to inspect facility per Licensee’s request to remove bedroom #2 for the use of the daycare. Licensee sent the department a new facility sketch showing all off-limit areas and the areas of the home she is requesting for the day care children to use. Fire clearance STD 850 was granted on August 16, 2022, LPA García has approved on this date Licensee’s request to place bedroom #2 off limits to day care children/parents.

The children will have access to use bathroom (located in between bedroom #1 and bedroom #2), hallway (that leads to restroom/bedrooms), living room (main daycare room), dining room, kitchen, front yard (fenced), porch and back yard (fenced). Licensee had latches on cabinets with any potentially hazardous material. Per licensee, areas off limits to children and parents include: Two (2) bedrooms and the Garage (located in the back yard area).

The LPA toured all areas used by children during this visit. LPA observed that there are no hazards in the home and there is a smoke detector and carbon monoxide detector in the hallway which were tested at 11:07 a.m., and are in operable condition.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with facility representative, Jeannette Herrera.


Report ends here page 1 of 1.
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Mireya Garcia
LICENSING EVALUATOR SIGNATURE: DATE: 01/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/11/2023
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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