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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198021405
Report Date: 10/09/2025
Date Signed: 10/09/2025 03:29:11 PM

Document Has Been Signed on 10/09/2025 03:29 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: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: 11DATE:
10/09/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:00 PM
MET WITH:Licensee, Jose RomeroTIME VISIT/
INSPECTION COMPLETED:
03:45 PM
NARRATIVE
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On 10/9/2025 at 2:00pm Licensing Program Analyst (LPA) Monica Ruiz conducted a case management inspection due to a self reported incident that occurred at the facility on 9/17/2025. LPA was greeted by Licensee, Jose Romero, to who the reason for visit was explained. There were 11 children present, also present were 2 assistants, names recorded.

LPA conducted interview with Licensee regarding this incident.



Licensee states that on 9/17/25 at approximately 10:45am, child 1(C1) was playing with cardboard blocks, building a wall, when he attempted to jump over it, tripped and hit head on the edge of the open front door. Child began to cry, Licensee comforted child and called mother immediately. Child's parents picked up child and took C1 to the doctor where C1 received 1 staple to the back of their head. C1 returned to care the next day with no complications, per Licensee.
LPA inspected indoor day care play area for hazards and none were observed. The indoor play area has a cushioned surface. LPA observed all outlets to be covered. Cleaning products and knives are kept in a locked cabinet in the kitchen inaccessible to children in care.

LPA observed the outdoor play area and observed there to be tricycles, a bike path, children's table, toys and a play structure. There is shade in the play yard. LPA advised Licensee to maintain cushioning under outdoor equipment and to maintain a fall space around climbing equipment.

LPA observed the surface that child 1 (C1) landed on to be cushioned to absorb a fall. LPA did not observe any defects in the surface of the cushioned outdoor play area or tripping hazards. LPA observed playground equipment to be in good condition, age appropriate, with no loose, sharp or pointed parts.

NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Monica Ruiz
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 10/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/09/2025
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: ROMERO FAMILY CHILD CARE
FACILITY NUMBER: 198021405
VISIT DATE: 10/09/2025
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During this visit LPA obtained the Childcare Facility Roster, reviewed child’s file, staff files and obtained a copy of text message communication between parents.

Licensee states that they will provide parents with a notice of injury and obtain their signature.

Licensee sectioned off the indoor play area to ensure children do not play near the front door.

The incident was reported to the Department within the required 48 hours of occurrence.

At this time, the facility is in compliance with California Code of Regulations Title 22, therefore no deficiencies were cited during today’s visit inspection.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Licensee, Jose Romero.

NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Monica Ruiz
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2025
LIC809 (FAS) - (06/04)
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