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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020564
Report Date: 05/07/2026
Date Signed: 05/07/2026 12:27:18 PM

Document Has Been Signed on 05/07/2026 12:27 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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:NUNEZ CERVANTES FAMILY CHILD CAREFACILITY NUMBER:
198020564
ADMINISTRATOR/
DIRECTOR:		A.NUNEZ CERVANTESFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 842-9075
CITY:LOS ANGELESSTATE: CAZIP CODE:
90022
CAPACITY: 14TOTAL ENROLLED CHILDREN: 10CENSUS: 3DATE:
05/07/2026
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Licensee Alejandra NunezTIME VISIT/
INSPECTION COMPLETED:
12:45 PM
NARRATIVE
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On Thursday, May 7, 2026 9:30AM, Licensing Program Analysts (LPAs) Monica Ruiz and Caroline Nguyen conducted an unannounced annual inspection and met with licensee Alejandra Nunez, whom the purpose of the visit was explained, and guided LPAs on a tour of the facility. Entrance Checklist LIC 126 was provided. Licensee states that there are 10 children enrolled. LPAs observed Licensee’s assistant/husband and 3 children present during this inspection including the licensee’s minor child. LPAs observed facility to be within ratio. Licensee stated operating hours are Monday – Friday, 06:30a.m. – 07:30 p.m.

This is a one-story home which consists of 3 bedrooms, 1 bathroom, living room, dining room, kitchen, and front yard (fenced). Areas accessible to children include living room, dining room, 1 bedroom (converted playroom), 1 bathroom, and front yard. Per licensee, areas off limits to children and parents include 2 bedrooms which have a child proof door knob lock.. The LPAs toured all areas used by children during this visit. According to the licensee, there are 2 small turtles on the premises. All individuals present in the home have obtained a criminal record clearance or exemption prior to working, residing, or volunteering in a licensed home and are identified on the attached LIC811.

LPAs observed the following required postings in the entry way of the facility; License, LIC 9148 Earthquake Preparedness Checklist, LIC 610A Emergency Disaster Plan, Pub 394 Notification of Parents Rights, and LIC 999 Facility sketch.

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NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Caroline Nguyen
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/07/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/07/2026
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.

LIC809 (FAS) - (09/23)
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Document Has Been Signed on 05/07/2026 12:27 PM - It Cannot Be Edited


Created By: Caroline Nguyen On 05/07/2026 at 11:32 AM
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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: NUNEZ CERVANTES FAMILY CHILD CARE
FACILITY NUMBER: 198020564

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/07/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416(c)
Personnel Requirements
(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, and record review, the licensee did not comply with the section cited above, licensee and assistant did not have current CPR certificates which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/04/2026
Plan of Correction
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Licensee provided proof of training registration and will complete in person training and provide CPR records to LPA by POC due date.
Type B
Section Cited
CCR
102416.1(a)(6)
Personnel Records
(a) Personnel records shall be maintained on each employee and shall contain the following information: (6) Documentation of completion of training on preventative health practices as required by Section 102416(c).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, and record review, the licensee did not comply with the section cited above, licensee and assistant did not have current preventative health practices which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/04/2026
Plan of Correction
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Licensee will complete training and provide records to LPA by POC due 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.
Katrina Chicote
NAME OF LICENSING PROGRAM MANAGER:
Caroline Nguyen
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 05/07/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/07/2026


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 05/07/2026 12:27 PM - It Cannot Be Edited


Created By: Caroline Nguyen On 05/07/2026 at 11:32 AM
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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: NUNEZ CERVANTES FAMILY CHILD CARE
FACILITY NUMBER: 198020564

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/07/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102418(g)
Immunizations
(g) The licensee shall document each child's immunizations as required by the California Code of Regulations, Title 17, Section 6070, and shall maintain such documentation for as long as the child is enrolled.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and record review, the licensee did not comply with the section cited above in 4 out of 5 children files did not have proof of immunizations which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/04/2026
Plan of Correction
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Licensee states she will locate proof of immunizations records and email them to LPA by POC due date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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.
Katrina Chicote
NAME OF LICENSING PROGRAM MANAGER:
Caroline Nguyen
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 05/07/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/07/2026


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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: NUNEZ CERVANTES FAMILY CHILD CARE
FACILITY NUMBER: 198020564
VISIT DATE: 05/07/2026
NARRATIVE
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LPAs inspected the facility for safety, comfort, cleanliness, ventilation and working phone cell phone. Tour began in living room where LPAs observed age-appropriate toys, materials, and equipment. Adjacent to the living room is the dining room and kitchen. Licensee’s home is open floor, and the living room, dining room, and kitchen are all together. LPAs observed child proof locks on the kitchen cabinets. LPAs observed appropriate napping equipment (cots and play pens). Storage of cots was discussed with Licensee. LPAs toured the bathroom and observed it in safe and sanitary conditions. The children use 1 bedroom located across from the living room that was converted into a playroom. LPAs observed age-appropriate toys and equipment for children. There’s also a first aid kit readily available and LPAs observed them to be complete. For ill isolation, licensee stated that the living room is utilized and parents are called for pick up. For ventilation, LPAs observed AC units and central air.

LPAs observed cleaning compounds items, stored underneath the kitchen sink, and observed a childproof lock in place, making it inaccessible for children to open. LPAs observed the knives and sharp objects stored inside a drawer cabinet with a lock cabinet making it inaccessible for children.



LPAs asked the licensee if there were any pets, poisons, firearms, or weapons, or bodies of water. Licensee stated they have 2 turtles in the front yard which were observed by LPAs to be locked in a crate, making them inaccessible to children. Licensee stated they do not have any of the other above mentioned and LPAs did not observe any. The licensee was informed that if any poisons (ex; drano, rat poison or items that fall into that category), firearms and weapons are purchased, it is required to be locked with a key or combination lock and firearm and ammunition must be stored separately.

Licensee stated the facility provides breakfast, lunch, snack, and dinner. LPAs informed licensee any food brought from the children's homes, the container shall be labeled with the child's name and properly stored or refrigerated. For water drinking, licensee stated they provide filtered water. Licensee stated that there are no children with severe food allergies nor on medication.

LPAs entered the bathroom and observed a working toilet, working sink with hand soap. LPAs reminded licensee and personal items (ex; shampoo, toothpaste, mouthwash, or items that fall into that category) must be made inaccessible to children. LPAs observed bathroom’s sink drawers to have child proof locks making them inaccessible to children.
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NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Caroline Nguyen
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/07/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2026
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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: NUNEZ CERVANTES FAMILY CHILD CARE
FACILITY NUMBER: 198020564
VISIT DATE: 05/07/2026
NARRATIVE
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Children are currently using the front yard for outdoor play. According to the licensee, children’s age-appropriate play equipment is stored inside the storage located in the yard. LPAs did not observe any hazardous materials. LPAs advised licensee to check with the American Standard Testing Materials for Playground Guidelines and/or to use the manufactures recommendations for the playground equipment in efforts to be more in line with safety guidelines.

At time of inspection, LPAs observed the required 2A10BC fire extinguisher located in the kitchen and the valve on the green area indicating fully charged and last serviced on 05/06/2026. LPAs observed the last emergency drill conducted on 05/07/2026. LPAs observed a carbon monoxide detector and smoke alarm combined and located in the living room and was operable.

LPAs observed licensee’s A-B-CPR Pediatric First Aid/ CPR certification and expires 03/9/2026, and has proof of immunization against Pertussis, MMR, and Influenza declination. Mandated reporter training requirements were discussed. Licensee was advised that the mandated reporter training must be completed every 2 years, and is available at www.mandatedreporterca.com.

LPAs also reviewed children’s roster, children files including sleep logs, and staff files. Maintenance of children and staff records were discussed.

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.

LPAs 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-andresources/safe-sleep as an additional resource.
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NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Caroline Nguyen
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/07/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2026
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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: NUNEZ CERVANTES FAMILY CHILD CARE
FACILITY NUMBER: 198020564
VISIT DATE: 05/07/2026
NARRATIVE
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LPAs also informed licensee’s assistant 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 child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California

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.

During the exit interview, licensee confirmed that there are no Registered Sex Offenders living in the facility and LPAs completed the RSO profile in FAS.

The following deficiencies were cited in accordance with Title 22 of the California Code of Regulations and Health & Safety Codes. Please see 809D for documentation of deficiencies.

Licensee will be referred to Technical Support Program (TSP).

A notice of site visit was given and must remain posted for 30 days. Failure to maintain posting as required


will result in a $100.00 civil penalty.

Exit interview conducted and report was reviewed with licensee Alejandra Nunez, along with appeal rights.

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NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Caroline Nguyen
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/07/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2026
LIC809 (FAS) - (06/04)
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