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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020159
Report Date: 02/27/2024
Date Signed: 02/27/2024 12:04:17 PM

Document Has Been Signed on 02/27/2024 12:04 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:CRUZ FAMILY CHILD CAREFACILITY NUMBER:
198020159
ADMINISTRATOR:ISELA CRUZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 736-9982
CITY:SOUTH GATESTATE: CAZIP CODE:
90280
CAPACITY: 14TOTAL ENROLLED CHILDREN: 11CENSUS: 4DATE:
02/27/2024
TYPE OF VISIT:Case Management - OtherANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Licensee Isela CruzTIME COMPLETED:
12:20 PM
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11:30 AM Licensing Program Analysts (LPAS) A. Padilla and T. Tran conducted a announced case management inspection at the above license facility. Upon arrival LPAS met with Licensee Isela Cruz. Present where licensee spouse 2 adult daughters and 1 minor daughter. 4 children where observed in care. All adults were check for background clearance and associated to the facility.

Today's inspection was for the purpose of observing addition of back yard space to use for children in care. 11:40 Licensee provided LPAS a tour of the additional back yard. LPA observed a trampoline located in the children's and immediately removed trampoline to inaccessible area of the yard. LPA obtained a declaration statement from licensee acknowledged that children will not have access to trampoline during child care hours.

A notice of site visit was given and must remain posted for 30 days.
Exit interview conducted and report was reviewed with the licensee Isela Cruz
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Anthony Padilla
LICENSING EVALUATOR SIGNATURE: DATE: 02/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/27/2024
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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