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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020807
Report Date: 12/13/2024
Date Signed: 12/13/2024 02:03:19 PM

Document Has Been Signed on 12/13/2024 02:03 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:ORTIZ FAMILY CHILD CAREFACILITY NUMBER:
198020807
ADMINISTRATOR/
DIRECTOR:		ORTIZ, MARYCRUZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 437-3099
CITY:PASADENASTATE: CAZIP CODE:
91103
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 3DATE:
12/13/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:00 PM
MET WITH:Licensee Marycruz OrtizTIME VISIT/
INSPECTION COMPLETED:
03:15 PM
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Licensing Program Analyst (LPA) Stephanie Li conducted an unannounced Case Management inspection due a decision and order received by the legal department regarding a criminal record for a previously associated individual on the licensee's mothers closed family child care home. Licensee's mother had a license at the same address and closed in 2021. LPA met with licensee Marycruz Ortiz and explained reason for visit. A COVID risk assessment was conducted. There were 3 children present and 1 staff. The facility was observed to be operating within the license capacity limitations.

On 12/06/2024, a decision and order was issued by the legal department for an individual that was associated to mother's previous license, with the same address. LPA verified that individual is not living in the home. Per licensee, he has not lived here for over 10 years. Per licensee, individual is her brothers stepson. Licensee received the report from her mother and contacted the DPSS legal division to request the individual not be connected to her family child care home. Per licensee, 4 adults live in the home (herself, mother, father, and brother in law) LPA and licensee confirmed that he is not on her Guardian roster. LPA obtained a declaration from licensee stating the individuals relationship and her attempts to clear her fcc of any relation to the decision and order. Per licensee, she is concerned about her license. She is attempting to obtain proof of his residents to send to the legal department. LPA provided licensee with child care lawyers contact information to reach out for guidance.

Based on information obtained during this investigation, no follow up is necessary regarding the incident reported. No deficiencies are being cited at this time.



A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with License Marycruz Ortiz.

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Stephanie Li
LICENSING EVALUATOR SIGNATURE: DATE: 12/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/13/2024
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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