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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198021405
Report Date: 11/15/2024
Date Signed: 11/15/2024 02:18:52 PM

Document Has Been Signed on 11/15/2024 02:18 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:ROMERO FAMILY CHILD CAREFACILITY NUMBER:
198021405
ADMINISTRATOR/
DIRECTOR:		ROMERO, JOSEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 356-3706
CITY:LOS ANGELESSTATE: CAZIP CODE:
90063
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 6DATE:
11/15/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Jose RomeroTIME VISIT/
INSPECTION COMPLETED:
01:50 PM
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Licensing Program Analyst (LPA) Veronica Martinez Garza conducted an unannounced Case Management Other inspection at the above facility on 11/15/24 at 1:00 p.m. Upon arrival LPA met with licensee Jose Romero. Census was taken.

The purpose of this inspection is to provide an amended report to a case management-deficiencies report dated 11/08/24.

At this time, there are no deficiencies being cited.

The Notice of Site Visit (LIC 9213) must remain posted for 30 days during the hours of operation after each site visit by a licensing representative, a civil penalty of $100 can be assessed.

Exit interview conducted and report was reviewed with the licensee Jose Romero.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE: DATE: 11/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/15/2024
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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