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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019103
Report Date: 01/09/2026
Date Signed: 01/12/2026 04:01:58 PM

Document Has Been Signed on 01/12/2026 04:01 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:PEREZ FAMILY CHILD CAREFACILITY NUMBER:
198019103
ADMINISTRATOR/
DIRECTOR:		ELIA PEREZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(213) 249-3759
CITY:NORWALKSTATE: CAZIP CODE:
90650
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 3DATE:
01/09/2026
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:53 PM
MET WITH:Elia PerezTIME VISIT/
INSPECTION COMPLETED:
03:05 PM
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ANNUAL/RANDOM VISIT CONDUCTED IN SPANISH

On January 9, 2026, at 12:25 PM, Licensing Program Analyst (LPAs) A. Carter and J. Duran conducted an Unannounced Annual / Random inspection and met with Elia Perez, the licensee. LPAs disclosed the purpose of the inspection and was granted entry into the facility. Licensee was provided a copy of the Facility Entrance Checklist.
All adults associated to the home were found to have criminal record clearance. There were 3 day care children and 1 assistant (S2) present during today’s inspection. Licensee states that there are currently 10 children enrolled. The facility’s hours of operation are Monday through Friday from 6 AM to 6 PM.

This is a single story home which consists of 4 bedrooms and 3 bathroom.
Care is mainly provided in the den adjacent to the kitchen. Areas accessible to children include: den (main care), the hallway bathroom, and the bedroom closest to the living room used for napping. Living room is used in passing to the day care area. Per Licensee, areas off-limits include 3 bedrooms, master bathroom, kitchen / dining room, and detached garage. The licensee understands that licensing staff may have access to off-limit areas during inspection visit if necessary. Per licensee, off limit areas doors are closed during operating hours, LPA observed doors to have safety knobs making them inaccessible to children in care. There is a screened fireplace in the living room observed by LPAs.
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 and comfort of the children.

LPAs observed required posted documentation: Facility License, Notification of Parent Rights and Earthquake Preparedness form. Report Continues Page 1 of 5
NAME OF LICENSING PROGRAM MANAGER: Denise Gibbs
NAME OF LICENSING PROGRAM ANALYST: Andrea Carter
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 01/09/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/09/2026
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.

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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: PEREZ FAMILY CHILD CARE
FACILITY NUMBER: 198019103
VISIT DATE: 01/09/2026
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LPAs observed Facility Roster, Facility Disaster Plan and Disaster drill log, with last drill conducted on August 20, 2025. Dual smoke/carbon monoxide detector observed and tested at facility at the time of inspection. LPAs observed the 2A10BC fire extinguisher with last service date of 02/14/24. LPAs advised licensee that fire extinguishers should be serviced or purchased new annually. Licensee states they have not been able to get in contact with a service provider, deficiency cited. The facility has central air and heating and maintains telephone service via landline and cell phone.

Inside the main care area (den), LPAs observed 1 infant inside a play yard, and 1 toddler on a napping cot. LPAs did not observe loose objects, bumpers, objects hanging, or objects attached to the play yard. The is a mounted tv, highchair against the wall, cubbies for diapering supplies, changing table, and age appropriate toys and learning materials available for children in care, free of loose and sharp parts. The on-limits bedroom had a highchair and toys. The children use the bathroom in the hallway. LPAs did not observe hazards in the bathroom. Sharp objects, detergents and cleaning compounds were inaccessible to children in care. Detergents and cleaning compounds are stored in locked cabinet under the sink, and knives are stored in an upper kitchen cabinet. The Licensee states that there is no poison in the home and understands that poison must be locked.

Food is provided for children in care. LPAs reminded licensee that any food brought from the children’s homes shall be labeled with child’s name and properly stored or refrigerated. Per the Licensee, there are no children enrolled that requires medication administered or any children with allergies. The isolation area for sick children waiting to be picked up is in the bedroom, supervised and away from the other children in care.

Per licensee, the children have access to the backyard for outside play. LPA observed age appropriate toys such as slides, toddler size cars, balls, tables and chairs. Play area is completely covered providing ample shading for children in care. LPA observed yard has adequate perimeter fencing through-out the property. Play area is free of loose and sharp articles or objects and all trees, shrubs, and plants are maintained. LPAs did not observe any bodies of water on/or around the premises.

Infant Care: Currently licensee has 2 infants enrolled. 1 under 12 months, and 1 over 12 months.
NAME OF LICENSING PROGRAM MANAGER: Denise Gibbs
NAME OF LICENSING PROGRAM ANALYST: Andrea Carter
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/09/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2026
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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: PEREZ FAMILY CHILD CARE
FACILITY NUMBER: 198019103
VISIT DATE: 01/09/2026
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Napping equipment does not block entrances or exits. Licensee was advised infants shall not be swaddled in care, and car seats shall only be used for transportation purposes and shall not be used for sleeping. LPAs discussed the Safe sleep regulation, including LIC 9227 Infant Sleep Plan for infants under 12 months, 15-minute sleep check documentation for infants 0 -24 months.

Children’s records were reviewed for (LIC) 282- Affidavit Regarding Liability Insurance, Immunization's Records, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights, and documentation of 15-minute Infant Sleep Check (0-24 months). All required licensing forms are in file.

Staff records were reviewed: for approved Pediatric First Aid & CPR certification, Criminal Record Statement, Employee Rights, Proof of immunizations against measles, pertussis, influenza or influenza declination, TB clearance or risk assessment, LIC 9108- Statement Acknowledging Requirement to Report Child Abuse and current Mandated Reporter Training Certificate. Licensee assistants’ Pediatric CPR / First Aid valid until: 11/20/27. Staff had proof of required immunizations. Assistants’ Mandated Reporter training is valid until 07/20/27. Licensee did not provide proof of Mandated Reporter training during the inspection visit, deficiency cited.

The following was discussed:
· Rooms that are off-limits need to be made inaccessible during operating hours. NO smoking, NO infant walkers, NO Johnny jumpers, NO saucer chairs, NO incline sleepers, or any other item that falls into that category are permitted in the facility. Effective January 1, 2010, Licensees of family childcare homes are required to ensure that at least one staff member with current training in Pediatric First Aid & CPR is on site at all times when children are present.
· Reporting Requirements: Changes should be reported to the Department as soon as they occur, such as construction, remodeling, telephone number changes and/or if you move from your home. Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing.
NAME OF LICENSING PROGRAM MANAGER: Denise Gibbs
NAME OF LICENSING PROGRAM ANALYST: Andrea Carter
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/09/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2026
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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: PEREZ FAMILY CHILD CARE
FACILITY NUMBER: 198019103
VISIT DATE: 01/09/2026
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During the inspection, children present were observed to be treated with dignity and respect, observed to be receiving safe, healthful, and comfortable accommodations, furnishings, and equipment, and free from corporal and/or unusual punishment. The Licensee confirms there are no smokers in the home, there are no pets in the home, there are no weapons or firearms in the home, and there are no pools, spas or other bodies of water on the premises.

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-and-resources/safe-sleep as an additional resource. 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.

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 childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.
NAME OF LICENSING PROGRAM MANAGER: Denise Gibbs
NAME OF LICENSING PROGRAM ANALYST: Andrea Carter
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/09/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2026
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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: PEREZ FAMILY CHILD CARE
FACILITY NUMBER: 198019103
VISIT DATE: 01/09/2026
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During the exit interview, the Licensee Elia Perez, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

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.

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.
The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site inspection by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.
Exit interview was conducted and report was reviewed with the Licensee Elia Perez.

Appeal Rights Given

...................................................................Report ends- Page 5 of 5...

NAME OF LICENSING PROGRAM MANAGER: Denise Gibbs
NAME OF LICENSING PROGRAM ANALYST: Andrea Carter
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/09/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2026
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 01/12/2026 04:01 PM - It Cannot Be Edited


Created By: Andrea Carter On 01/09/2026 at 02:41 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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: PEREZ FAMILY CHILD CARE
FACILITY NUMBER: 198019103

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/09/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(1)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (1) Fireplaces and open face heaters shall be screened to prevent access by children. The home shall contain a fire extinguisher and smoke detector device which meet standards established by the State Fire Marshall.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in 2 out of 2 fire extinguishers was last serviced on 2/14/24 which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/09/2026
Plan of Correction
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Licensee states they will have fire extinguisher serviced or purchased new and send service tag or purchase receipt as proof of correction by agreed upon date.
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
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Based on record review, the licensee did not comply with the section cited above in licensee could not provide proof of Mandated Reporter trainin during inspection visit which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/09/2026
Plan of Correction
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Licensee states they will complete Mandated Reporter Training and submit certificate to LPA via email as proof of correction by agreed upon 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.
Denise Gibbs
NAME OF LICENSING PROGRAM MANAGER:
Andrea Carter
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 01/09/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/09/2026


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