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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019544
Report Date: 05/25/2023
Date Signed: 05/25/2023 04:28:23 PM

Document Has Been Signed on 05/25/2023 04:28 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: 6DATE:
05/25/2023
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Sandra Benitez, LicenseeTIME COMPLETED:
04:45 PM
NARRATIVE
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On 5/25/23 Licensing Program Analysts (LPAs) Alicia Mooberry and Rosaura Valenzuela conducted an unannounced Case Management inspection in Spanish as requirement of the three (3) years probation beginning on 10/07/21. LPA arrived at 2:45 at the facility and met with Gabriela Hinojosa-Reyes, Assistant. There were six (6) daycare children (including 1 infant) napping in the childcare room. At approximately 2:50pm, Fernando Benitez(A1), Licensee's adult relative arrived with licensee's minor child. Record review shows that A1 has a background clearance that is closed. The licensee provided a DOJ clearance document. LPA will further review the background clearance and determine if a deficiency is warranted and will to be cited at a later visit. The licensee will have A1 move out of the home until background clearance received.. LPA's toured the facility. Sandra Benitez arrived at the facility at approximately 3:00pm.

LPA observed that there are safety gates at the base of the stairs leading to the 2nd floor. There are also gates at entrances to the kitchen and in the doorway leading to the hallway and bathroom. Sandra Benitez, Licensee, who provided a tour of the facility. Individuals residing in the home were discussed and noted. Licensee stated A1 moved into the home about a month a half ago. Licensee did not report the change in household this poses a potential risk to the health and safety of persons in care.

All areas on the facility sketch that are accessible to children in care were inspected for safety, comfort, and cleanliness.


LPAs observed that the cabinet in the bathroom that holds cleaning supplies did not have the safety lock, this can be a potential risk the the health and safety of children in care. Licensee CPR/First Aid expires 09/2023. The required posting including the facility license and Parent's Rights poster were observed in a prominent location in the living room.

LPA inspected the enclosed outdoor play area. LPA reminded licensee to ensure the gate leading to the side yard is always closed and locked.

Based on record reviews and LPA observations, 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: 05/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/25/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
Document Has Been Signed on 05/25/2023 04:28 PM - It Cannot Be Edited


Created By: Alicia Mooberry On 05/25/2023 at 03:55 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: BENITEZ FAMILY CHILD CARE
FACILITY NUMBER: 198019544

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/25/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/30/2023
Section Cited
CCR
102416.2(a)(2)

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The licensee shall report... Any change in household composition including adults moving in or out of the home and anyone living in the home who reaches his or her 18th birthday.
This requirement is not met as evidenced by:
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The licensee completed an updated LIC 279 on this date. An LIC 627B will be completed and send to the department by POC due date
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Per interview and observations the licensee failed to report that her adult family member has moved into the home for over a month. This poses a potential risk to the health and safety of children in care.
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Type B
05/25/2023
Section Cited
CCR102417(g)

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(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not be limited to:
This requirement is not met as evidence by:
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Licensee placed a safety latch on the bathroom cabinet. Per licensee she will nesure the safety lathch is always placed after the cleaning is done.
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LPA observed that the bathroom cabinet used by children in care had cleaning products and did not have a latch or lock. Due to the children were sleeping and there are safety gates at hallway leading to the bathroom this poses a potential 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:Valarie Cook
LICENSING EVALUATOR NAME:Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:
DATE: 05/25/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/25/2023


LIC809 (FAS) - (06/04)
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