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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198018520
Report Date: 06/24/2022
Date Signed: 06/24/2022 04:29:44 PM

Document Has Been Signed on 06/24/2022 04:29 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:TAMAYO FAMILY CHILD CAREFACILITY NUMBER:
198018520
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 1DATE:
06/24/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
04:00 PM
MET WITH:Socorro Tamayo, LicenseeTIME COMPLETED:
04:40 PM
NARRATIVE
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On 6/24/22 Licensing Program Analyst (LPA) Fabiola Vasquez conducted a Case Management Deficiencies Inspection to address deficiencies observed during today’s inspection.

During a walk-through of the facility LPA Vasquez observed in the back yard an above ground pool, LPA observed that the pool does not have a cover or fence. LPA observed a chair next to the pool, accessible to children.

The following deficiencies on the attached LIC 809 deficiencies page is being cited in accordance with CA code of Regulations Title 22.

A copy of this report shall be provided 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). Acknowledgement of Receipt (LIC 9224 form) must be maintained in each child’s file immediately upon receipt from parent. Director was provided with a copy of the Acknowledgement of Receipt of Licensing Reports (LIC 9224) Form during this visit.

Exit interview was conducted with licensee, Socorro Tamayo, report and appeal rights were provided.



The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.
SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Fabiola Vasquez
LICENSING EVALUATOR SIGNATURE: DATE: 06/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/24/2022
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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Document Has Been Signed on 06/24/2022 04:29 PM - It Cannot Be Edited


Created By: Fabiola Vasquez On 06/24/2022 at 04:17 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: TAMAYO FAMILY CHILD CARE
FACILITY NUMBER: 198018520

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/24/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/25/2022
Section Cited
CCR
102417(g)(5)

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102417 Operation of a Family Child Care HomeAll licensees shall ensure the inaccessibility of pools **above-ground), fixed-in-place ** similar bodies of water through a pool cover or by surrounding the pool with a fence.
This requirement was not met as evidenced by:
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Per licensee, the pool is going to be removed this weekend. Will send proof to LPA via email, by due date. POC: 6/27/22.
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LPA Vasquez observed in the back yard an above ground pool, LPA observed that the pool does not have a cover or fence. LPA observed a chair next to the pool, accessible to children.

This poses an immediate risk to the health and safety of children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Claudia Guangorena
LICENSING EVALUATOR NAME:Fabiola Vasquez
LICENSING EVALUATOR SIGNATURE:
DATE: 06/24/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/24/2022


LIC809 (FAS) - (06/04)
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