198019086-6-11-2025-54-CC-FWHE-DHJVP9-20250611163621

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198019086
Report Date: 06/11/2025
Date Signed: 06/11/2025 04:36:32 PM

Document Has Been Signed on 06/11/2025 04:36 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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	ZAMORA FAMILY CHILD CARE		FACILITY NUMBER:	198019086
ADMINISTRATOR/ DIRECTOR:	ELVIRA ZAMORA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 649-9251
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90002
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 9	DATE:	06/11/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:45 PM
MET WITH:	Elvira Zamora, Licensee		TIME VISIT/ INSPECTION COMPLETED:	05:00 PM

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	Licensing Program Analyst (LPA) Franchesca White arrived at the above facility for the purpose of an unannounced Annual - Random Inspection. LPA White announced the purpose of the visit and was granted entry into the facility by Licensee Elvira Zamora. The hours of operation are 8:00 a.m. to 5:00 p.m. (Monday - Friday). There are 10 children enrolled and 9 present at the time of inspection. There are three volunteers present at the time of inspection. All adults in the home were discussed and have current criminal background clearance. The parent board was observed to have the following documents: License Parent's Rights Earthquake Preparedness Emergency Disaster Plan The fire drill log was available at the time of inspection with the most recent drill conducted 4/26/2025. The facility roster was available during today's inspection and was observed to be current at the time of inspection. All life saving devices were observed to be operable at the time of inspection. The carbon monoxide detector is located in the located in the hallway of the main care space in the living room. The Smoke Detector is located in the hallway that leads to the living room. The 2A 10BC fire extinguisher is located near the back door with a service tag date 2/26/2025. This is a single story home which consists of three bedrooms and two bathrooms, kitchen, living room, and converted detached garage. Areas used by the children include the living room. ................................................................Report Continues 1 of 4 Pages................................................

NAME OF LICENSING PROGRAM MANAGER: Denise Gibbs
NAME OF LICENSING PROGRAM ANALYST: Franchesca White
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/11/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2025

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: ZAMORA FAMILY CHILD CARE	FACILITY NUMBER: 198019086
	VISIT DATE: 06/11/2025

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Licensee states the living room is used for eating and napping, converted detached garage for day care activity space, and Bathroom 1(located down hallway in the home). Per Licensee, areas off limits to children and parents include all bedrooms (Bedrooms 1, 2, and 3), Bathroom 2, and Kitchen.

Per Licensee, off limit bedrooms are also locked during operating hours. At 2:30 p.m., observed doors to be locked and signs posted on doors stating area is off limits.

All areas identified on the facility sketch as accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for the safety of the children. There is a working telephone maintained in the home. Licensee states that there are no bodies of water. LPA White did not observe any bodies of water. Licensee has a small pet that is kept inside the home and is inaccessible to children in care with the use of a baby gate in the living area of the home. Licensee states that there are no firearms or weapons in the home. LPA White did not observe any firearms or weapons in the home.

At 2:35 p.m., LPA White observed the outdoor activity space to have child size tables and chairs, blue mats for sitting, shelves with plastic blocks, puzzles, art supplies, dramatic play toys, and other age appropriate toys, free of loose and sharp parts available for children at time of inspection. LPA White observed the play area to be completely fenced in with a slide, climbing gym for children to play, bicycles, and tricycles for children. All play equipment has a soft cushioned surface perfect for absorbing falls. Play area is completely covered with a tent providing ample shading for children in care.

At 2:50 p.m., LPA White observed the indoor activity space located in the detached garage to be fully supplied with toys, art activities, and centers for dramatic play, science, and space for circle time. There are academic postings covering the walls of the facility. There are round tables for multiple small group activities.

At 3:00 p.m., LPA White observed the living room to have an entrance through the side door of the home. LPA White observe the living room to have a large round table in the center of the room. Licensee states that children take there meals in the living room. Licensee states that she or one of her volunteers prepare the lunch for the children in care. LPA White observed the room to have couch, a large chair for adult sitting. child size chairs for day care children to sit at the tables. Thee is large flat screen tv mounted to a tv stand near the hallway entrance to the living room.
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NAME OF LICENSING PROGRAM MANAGER: Denise Gibbs
NAME OF LICENSING PROGRAM ANALYST: Franchesca White
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/11/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2025

LIC809 (FAS) - (06/04)

Page: 3 of 5

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: ZAMORA FAMILY CHILD CARE	FACILITY NUMBER: 198019086
	VISIT DATE: 06/11/2025

NARRATIVE

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At 3:15 p.m., LPA White observed the back room to be the napping space for sleeping children. LPA observed cots for the children to sleep with fitted sheets on each cot for the children. Room was clean and ventilated for the children. Licensee states this is where she keeps her files, and first aid kit.

At 3:30 p.m., LPA White observed the staff files to have the following documentation:
Licensee Elvira Zamora: Mandated Reporter Training Certification - 7/1/2023 (expiration date:7/2025) Reminder given of the renewal month; CPR/1st Aid certification - 7/19/2023 (expiration date: 7/2025) Reminder given of the renewal month; Immunization records were available at the time of inspection.

All staff record review documented on LIC 859. All files had required department documentation at the time of inspection.

At 3:45 p.m., LPA White reviewed the children's files. All files had required department documentation as well as immunization records at the time of inspection.

The following were discussed:
All areas used by children were inspected for safety, comfort, cleanliness, telephone service (cell phone), ventilation and heating (central air and heat).
Licensee Elvira Zamora was reminded that all adults 18 and over, 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 Child Care Center. 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 Elvira Zamora and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee licensee Elvira Zamora of the importance of checking for 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.

................................................................Report Continues 3 of 4 Pages...............................................

NAME OF LICENSING PROGRAM MANAGER: Denise Gibbs
NAME OF LICENSING PROGRAM ANALYST: Franchesca White
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/11/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2025

LIC809 (FAS) - (06/04)

Page: 4 of 5

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: ZAMORA FAMILY CHILD CARE	FACILITY NUMBER: 198019086
	VISIT DATE: 06/11/2025

NARRATIVE

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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 Elvira Zamora 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.

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

Based on today's inspection,there will be no deficiencies cited in accordance with California Title 22 Regulations.

A notice of site visit was given and must remain posted for 30 days. Failure to post will result in a $100 civil penalty.

Exit interview conducted and report was reviewed with the licensee Elvira Zamora. PIN 22-05-CCP Page Six

A copy of the report and appeal rights was given to Licensee Elvira Zamora.

......................................................Report Ends Here 4 of 4 Pages..............................................................

NAME OF LICENSING PROGRAM MANAGER: Denise Gibbs
NAME OF LICENSING PROGRAM ANALYST: Franchesca White
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/11/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2025

LIC809 (FAS) - (06/04)

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