198021327-2-4-2026-33-CC-MRUZ-DQYT7Y-20260204132930

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198021327
Report Date: 02/04/2026
Date Signed: 02/04/2026 01:29:43 PM

Document Has Been Signed on 02/04/2026 01:29 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:	FLORES-SEGURA FAMILY CHILD CARE		FACILITY NUMBER:	198021327
ADMINISTRATOR/ DIRECTOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 4	DATE:	02/04/2026
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	12:30 PM
MET WITH:	Licensee,Blanca Flores-Segura		TIME VISIT/ INSPECTION COMPLETED:	02:15 PM

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On February 4, 2026 Licensing Program Analyst (LPA) Monica Ruiz conducted an unannounced case management-licensee initiated at the above facility. The purpose of the inspection is for increase capacity. LPA met with Licensee, Blanca Flores Segura who guided analyst on a tour of the facility. Also present during this inspection were 4 children and Licensee’s assistant. Per licensee, there are 8 children enrolled. Operation hours are Monday – Friday 06:00 a.m. – 06:00 p.m.

This is a one-story home which consists of 3 bedrooms, 1 bathroom, living room, kitchen, front yard (fenced), and a basement.

Areas accessible to children include living room, bathroom, and front yard (fenced) for play. Areas off limits to children and parents include 2 bedrooms, kitchen, and basement.

LPA observed one cat in an off limits bedroom and one small breed dog that is kept in the side patio area. All individuals present in the home have obtained criminal record clearance or exemption prior to working, residing, or volunteering in a licensed home and are identified on the attached LIC811.

All areas identified on the facility sketch that are accessible for children to use were inspected for safety comfort, and cleanliness. Tour began in the living room where LPA observed age-appropriate toys, materials, and equipment for children. Adjacent to the dining room is the kitchen. LPA observed child protective covers on the knobs on the stove and magnetic child safety latches on all the kitchen cabinets, including the refrigerator. LPA observed kitchen knives to be stored on a high shelf, inaccessible to children in care. LPA and Licensee discussed kitchen accessibility.

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NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Monica Ruiz
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 02/04/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2026

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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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: FLORES-SEGURA FAMILY CHILD CARE	FACILITY NUMBER: 198021327
	VISIT DATE: 02/04/2026

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Adjacent to the living room, is Bedroom #1 with 1 crib used for sleeping infants, per local fire department’s recommendation. Bedrooms #2 and #3 are kept closed during daycare hours and have child protective knobs. Licensee also has a crib in the living room and a play pen in storage that is readily available for infant day care children to use. Older children nap on cots in the living room.

The bathroom is accessible to children in care and is in safe and sanitary conditions. There is also a first aid kit readily available.

LPA toured the front play yard that will is used for outdoor play. There is shade and age-appropriate play equipment for children in care, such as an infant slide, dramatic play house, blocks, and sensory toys. LPA did not observe any objects that could be hazardous to children in care. Licensee understands that children should be supervised at all times while outdoors.

There is telephone service via a cell phone that remains in the facility during hours of operation. There is ventilation and heating. Detergents, cleaning compounds, medications, and other items which could pose a danger to children were observed to be inaccessible to children.

Per licensee, there are no firearms or weapons stored in the home or any bodies of water, and none were observed on this day.

LPA reviewed Pediatric First Aid and CPR certification, expires 3/2026 and current Mandated Reporter Training Certificate. Licensee's mandated reporter training expires 3/2026.

LPA informed licensee that upon hiring an assistant, the following is required prior to the assistant being present in the home: fingerprint clearance, 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 a Mandated Reporter Training Certificate. Licensee has hired an assistant and has records on file.

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.

NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Monica Ruiz
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 02/04/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2026

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: FLORES-SEGURA FAMILY CHILD CARE	FACILITY NUMBER: 198021327
	VISIT DATE: 02/04/2026

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Because the licensee rents the home, proof of landlord notification is required. The LPA observed the Property Owner/Landlord Notification form (LIC9151) that the applicant confirms was provided to the property owner/landlord.

The facility has requested an increase in capacity from 8 to 14. Fire clearance was granted on 1/30/26. Capacity Increase will be granted, pending final file review. License will be amended to reflect new capacity of fourteen (14) children.

At this time, the licensee is in compliance with California Code of Regulations Title 22. No deficiencies cited.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee Blanca Flores-Segura.

NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Monica Ruiz
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 02/04/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2026

LIC809 (FAS) - (06/04)

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