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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019544
Report Date: 04/11/2022
Date Signed: 04/11/2022 03:49:28 PM

Document Has Been Signed on 04/11/2022 03:49 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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:BENITEZ FAMILY CHILD CAREFACILITY NUMBER:
198019544
ADMINISTRATOR:SANDRA BENITEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 359-5551
CITY:BELL GARDENSSTATE: CAZIP CODE:
90201
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 7DATE:
04/11/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:TIME COMPLETED:
04:00 PM
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Visit conducted in Spanish
Licensing Program Analyst (LPA) Alicia Mooberry conducted a Case Management inspection to facility as part of the requirement of the three (3) years probation beginning on 10/07/21. based on the Stipulation and Waiver and Order dated September 28, 2021. The Stipulation and Waiver and Order was adopted by the Department and became effective October 7, 2021.

LPA met with Sandra Benitez, Licensee, who provided tour of facility. All areas on the facility sketch including off limit areas were inspected. There were 7 children including, 2 infants, observed napping in the daycare room on this date and Gabriela Hinjosa-Reyes, Assistant. All adult present have obtained a criminal background clearance. Individuals residing in the home were discussed and noted.

Licensee maintains a current facility roster. Licensee CPR/First Aid expires 09/2023. Child files were reviewed and found complete. App required posting were observed in a prominent location.

Toxins and sharp items in are stored inaccessible to children. LPA did not observe any hazards in the bathroom that is used by the child in care


Licensee maintains license and other required LIC forms posted in a visible area in the dining room.

LPA informed licensee on the following: keeping in compliance with Title 22 Regulations, criminal record clearances (civil penalties/prior to presence), mandated reporting, reporting requirements, supervision, terms of license, and record keeping.


Based on record reviews and LPA observations, no deficiencies were cited during this inspection.

Exit interview conducted with licensee Sandra Benitez.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE: DATE: 04/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/11/2022
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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