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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198021426
Report Date: 10/15/2024
Date Signed: 10/15/2024 01:35:08 PM

Document Has Been Signed on 10/15/2024 01:35 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:ZAVALA NUNEZ FAMILY CHILD CAREFACILITY NUMBER:
198021426
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 6CENSUS: 6DATE:
10/15/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:45 PM
MET WITH:Licensee Karen ZavalaTIME VISIT/
INSPECTION COMPLETED:
02:00 PM
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Licensing Program Analyst (LPA) Stephanie Li conducted a Case Management - Licensee Initiated visit for the purpose of evaluating a request for a capacity increase from 8 to 14. LPA met with Licensee Karen Zavala, who guided LPA on a tour. There are 2 adults and 2 minor children living in the home. There were 6 children present during this visit. Per Licensee, there are 6 children currently enrolled, includes own 2 children. The hours of operation are Monday through Friday 6:30am-5:00pm. Fire clearance for a capacity of 14 was granted on 10/01/2024.

All areas identified on the facility sketch were inspected. The facility is a one story home that consist of 3 bedrooms, 2 bathrooms, kitchen, living room, childcare room (converted garage), front yard, and backyard (separated yard areas). The areas accessible to children are the living room, kitchen, 1 bathroom, child care room (converted garage) and right side back yard. The areas inaccessible to children are 3 bedrooms, 1 bath rooms, and left side back yard and shed.

The Licensee uses the back right yard for outdoor play. The outdoor play area was observed to be fenced. Licensing staff observed that the side yard has toys and other materials for children to play with.

The home was inspected for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children. There are age-appropriate toys and equipment on the premises. Licensee joined the Angels food program in July and prepares snacks and meals per food program guidelines. Licensee does not provide transportation and is currently only serving children ages 0-5.

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SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Stephanie Li
LICENSING EVALUATOR SIGNATURE: DATE: 10/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/15/2024
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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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: ZAVALA NUNEZ FAMILY CHILD CARE
FACILITY NUMBER: 198021426
VISIT DATE: 10/15/2024
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The valve on the required 2A 10BC fire extinguisher indicates fully charged and was serviced on 7/12/24, as indicated on service tag. Licensee stated there are no weapons or firearms in the facility. Smoke and carbon monoxide detectors were tested and are operable on this day. Licensee has current CPR/First Aid certification, expires on 06/2026 and Mandated Reporter Training Certificate, expires on 03/2026.

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.



LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleephttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep

LPA also informed licensee of the importance of checking for 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 childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.



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SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Stephanie Li
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2024
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: ZAVALA NUNEZ FAMILY CHILD CARE
FACILITY NUMBER: 198021426
VISIT DATE: 10/15/2024
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During the exit interview, the Licensee, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

At this time, the licensee is in compliance with California Code of Regulations Title 22. No deficiencies cited. The capacity increase request for a Large Family Child Care will be submitted for review. Once a capacity increase is issued, the Licensee is required to adhere to the terms and limitations as stated on the license.


A notice of site visit was given and must remain posted for 30 days. Appeal rights were provided. Exit interview conducted and report was reviewed with the Licensee, Karen Zavala.

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SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Stephanie Li
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2024
LIC809 (FAS) - (06/04)
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