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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020193
Report Date: 05/07/2025
Date Signed: 05/07/2025 12:09:35 PM

Document Has Been Signed on 05/07/2025 12:09 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:MONTES FAMILY CHILD CAREFACILITY NUMBER:
198020193
ADMINISTRATOR/
DIRECTOR:		MAYRA ALEJANDRA MONTESFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 293-5154
CITY:BELLFLOWERSTATE: CAZIP CODE:
90706
CAPACITY: 14TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
05/07/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:55 AM
MET WITH:Mayra Alejandra Montes, LicenseeTIME VISIT/
INSPECTION COMPLETED:
12:15 PM
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Licensing Program Analysts (LPAs) Alicia Mooberry and Tyler Reyes conducted an unannounced Annual Random Inspection on this date. LPA met with the Licensee Myra Montes and informed her of the purpose for the visit. LPA provided the inspection Entrance Checklist (LIC 126). Licensee guided LPA on a tour of the facility. There were 0 children present during the inspection. All adults present during the inspection have obtained a criminal record clearance or exemption. Individuals residing in the home have been discussed and noted. Per licensee days/ hours of operation are Monday through Friday 6:00 AM to 6:00 PM. Licensee offers overnight care, LPA Mooberry discussed overnight care guidelines and regulations.

This is a one story home which consists of four bedrooms, two bathrooms, kitchen/dining room, living room, detached garage and converted room, side yard and backyard (fenced).


Areas accessible to children: Living room, kitchen/dining room, bathroom (between Bedroom 1 and 2), bedroom 1 and bedroom 3 (infant room), backyard.
Per Licensee and facility sketch, areas off limits to children include: Detached garage and room, bedroom 2 and 4 with en suite bathroom (locked). The restroom that children use was observed safe and sanitary. LPA observed appropriate sleeping arrangements (cots) and and crib.

All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. The following was observed and reviewed during this inspection:

LPA observed the facility license, Publication (PUB) 394- Notification of Parent Rights and Licensing Form (LIC) 9148- Earthquake Preparedness form posted in kitchen wall. Licensee was advised/reminded to post the required posted documentation in a location visible to parent/guardians of children in care. LPA Reyes reviewed Children’s Roster form LIC 9040 and Emergency Disaster Plan (LIC 610A)



Page 1 – Report Continues
NAME OF LICENSING PROGRAM MANAGER: Denise Gibbs
NAME OF LICENSING PROGRAM ANALYST: Alicia Mooberry
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 03/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/04/2025
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 3
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: MONTES FAMILY CHILD CARE
FACILITY NUMBER: 198020193
VISIT DATE: 05/07/2025
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The home is observed to be clean and orderly. Smoke and carbon monoxide detectors in hallway and bedrooms used by children were tested and are operable. Fire extinguisher indicated fully charged and purchase receipt date 3/5/25, Licensee was reminded that fire extinguisher needs to be serviced yearly. The home maintains telephone service via cell phone.

There are toys and other age-appropriate material available. LPA observed that cleaning compounds are in kitchen and bathroom locked cabinets inaccessible to children in care.

Licensee states that there are no poisons stored in the home and understands that all poisons must be locked, not only inaccessible to children.

Per Licensee there are no firearms or weapons stored in the home. Per Licensee, area for sick children waiting to be picked up in in the living room supervised and away from the other children.

Outdoor play area is in the back yard and observed to be fenced. LPA observed that the outdoor yard has toys and other age appropriate materials. There is a swingset and climbing structure anchored to the ground, with grass as cushion. The facility does not have a pool or similar bodies of water. LPA observed 1 small dog, that interacts with children in the home. Per licensee, the backyards is cleaned daily prior to children going outside.

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)

Licensee and Staff 1 records were reviewed for approved Pediatric First Aid and CPR certification, LIC-501: Personnel Record, LIC 508-Criminal Record Statement, LIC 9052- Employee Rights, Proof of immunizations against measles, pertussis and influenza or influenza declination, TB clearance or risk assessment, LIC 9108- Statement Acknowledging Requirement to Report Child Abuse and current Mandated Reporter Training Certificate. Staff 1 has incomplete file.

Per licensee, there not an assistant working regularly due to low enrollment licensee understands that If no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home, max capacity 8.

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NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Alicia Mooberry
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2025
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: MONTES FAMILY CHILD CARE
FACILITY NUMBER: 198020193
VISIT DATE: 05/07/2025
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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.

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 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 child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

No deficiencies are cited as a result of this inspection. During the exit interview, the licensee Myra Montes, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS. A notice of site visit was given and must remain posted for 30 days. Appeal Rights were discussed and provided. Exit interview conducted and report was reviewed with the licensee Myra Montes

NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Alicia Mooberry
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2025
LIC809 (FAS) - (06/04)
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