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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198022162
Report Date: 06/15/2026
Date Signed: 06/15/2026 12:25:59 PM

Document Has Been Signed on 06/15/2026 12:25 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:CUERVO & ESCAMILLA FAMILY CHILD CAREFACILITY NUMBER:
198022162
ADMINISTRATOR/
DIRECTOR:
CUERVO, GUILLERMO/ESCAMILLFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 397-4038
CITY:MONTEBELLOSTATE: CAZIP CODE:
90640
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
06/15/2026
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:04 AM
MET WITH:Valentina EscamillaTIME VISIT/
INSPECTION COMPLETED:
12:40 PM
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Licensing Program Analyst (LPA) Veronica Martinez Garza conducted an announced Pre-Licensing inspection at the above facility on 06/15/26 at 09:04 a.m. The inspection conducted on this date is for a pending change of location application for a Large family child care home. The Monterey Park Regional Office received an approved fire clearance on 05/21/26. The previous home was licensed under facility number #1980221667.At 9:10 a.m., LPA met with applicant Valentina Escamilla who guided analyst on a tour of the facility. Operation hours will be Monday through Sunday 22 hours a day. Applicants state they will care for children 0 months – 12 years old. Applicant Guillermo Cuervo later arrived.

All areas identified on the facility sketch were inspected, including but not limited to, off limit areas.

This is a two-story home which consists of 5 bedrooms, 3 bathrooms, living room, family room, kitchen, dining room, front yard, back yard, storage room, and garage. Per applicant, family members residing in the home are 3 adults and 0 minors. Applicant’s state there are no pets on the premises. All individuals present or living in the home have obtained a criminal record clearance or exemption prior to working, residing, or volunteering in a licensed home.

• Day care areas: living room, dining room, family room, 1 bedroom (downstairs) and 1 bathroom (downstairs).

• Off limit areas: 4 bedrooms, 2 bathrooms, kitchen, storage room, front yard, back yard, and garage.

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NAME OF LICENSING PROGRAM MANAGER: Ana Chico
NAME OF LICENSING PROGRAM ANALYST: Veronica Martinez-Garza
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/15/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 7
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: CUERVO & ESCAMILLA FAMILY CHILD CARE
FACILITY NUMBER: 198022162
VISIT DATE: 06/15/2026
NARRATIVE
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Areas that will be used by children were inspected for safety, comfort, and cleanliness. LPA toured the living room where LPA observed furniture and a barricaded fireplace. LPA then toured the dining room where LPA observed a dining room table with chairs. LPA was then guided to the family room where LPA observed a well mounted child proof gate and 2 steps going down the room which was converted into the main day care room. LPA observed child sized chairs, tables, (1) play pen, age-appropriate toys, materials and equipment. Tour then continued towards the entrance of the home where 1 bedroom, 1 bathroom, storage, and garage are located. According to the applicant, children and infants will utilize the bedroom for nap time. LPA observed 3 cribs and 1 changing table. There were cots stores in the bedroom closet. The children’s bathroom is located outside of the bedroom. LPA observed that the children’s bathroom is safe and in sanitary conditions. The storage room is located across from the bedroom. LPA observed items that do not pose a risk to children. Adjacent to the storage room is the garage door which was observed to be closed/locked. Applicant guided analyst to the second floor where LPA observed a well mounted child proof gate at the bottom of the stairs, 3 bedrooms, 1 office, and 2 bathrooms. Bedrooms were not fully furnished. According to the applicant, the kitchen will be off-limits and has placed a well mounted child proof gate between the dining room and kitchen and from the family room and kitchen. When children walk to and from the family room to the bedroom, bathroom, or entrance/exit the applicants will ensure that children are supervised since there is direct access to the kitchen. Applicants will also ensure that all sliding doors connected to the rooms accessible to children will be locked to prevent children having access to the back yard.

Per applicant, there are no poisons on the premises. The applicants were advised that any poisons must be locked with a key or combination lock.

LPA observed (1) fire extinguisher: in the family room. The 2A10BC fire extinguisher was fully charged and was serviced on 01/13/26, per the attached service tag. The applicants were advised that the fire extinguisher must be serviced yearly or purchase a new one and keep receipt.

According to the applicant, food will be provided to all children in care. The applicants were advised that if food is brought from the children’s homes, all containers must be labeled with the child’s name and properly stored or refrigerated.

Detergents, cleaning compounds, medications, and other items which could pose a danger to children were observed to be inaccessible. The applicant states that there are no poisons in the home and understands that storage areas for poisons must be locked with a key or combination lock.

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NAME OF LICENSING PROGRAM MANAGER: Ana Chico
NAME OF LICENSING PROGRAM ANALYST: Veronica Martinez-Garza
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2026
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: CUERVO & ESCAMILLA FAMILY CHILD CARE
FACILITY NUMBER: 198022162
VISIT DATE: 06/15/2026
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Per applicant, children will not use the back yard for outdoor play. LPA toured the backyard and observed a fire pit and advised the applicant that it must remain closed. LPA also observed a BBQ grill and smoker. Applicants understand that children should be supervised at all times.

At 9:19 a.m., smoke and carbon monoxide detectors were observed to be operable.

The applicant has completed the required Health and Safety Training and Pediatric First Aid and CPR expires 07/27/27. There are first aid supplies available.

Telephone service is via a cell phone that will remain at the facility during operation hours. Applicants home is equipped with central air conditioner with heat.

Per applicant, there are no firearms, no weapons or bodies of water on the premises. LPA did not observe any of the above mentioned during this inspection.

The following was discussed with the licensee:

In the absence of the licensee a qualified adult must be present supervising the children; a qualified adult is an individual who has a valid and current Pediatric First Aid and CPR training, Immunization (TB, TDAP, MMR, Influenza), mandated reporter training and a valid criminal record clearance associated to the facility license.

• Annual fees must be paid promptly and by the due date or a late fee shall be assessed and/or the License may be terminated.

• The fire extinguisher type 2A-10BC must be serviced annually or purchased annually.

• Smoke and carbon monoxide detectors should be checked, and batteries replaced as needed.

• Reporting Requirements: Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your home.

• Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing. LIC624B was provided.

• Fire and safety drills must be performed every six months and documented for review by the Department.

• Smoking is prohibited in a family child care home.

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NAME OF LICENSING PROGRAM MANAGER: Ana Chico
NAME OF LICENSING PROGRAM ANALYST: Veronica Martinez-Garza
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2026
LIC809 (FAS) - (06/04)
Page: 4 of 7
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: CUERVO & ESCAMILLA FAMILY CHILD CARE
FACILITY NUMBER: 198022162
VISIT DATE: 06/15/2026
NARRATIVE
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Licensee was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

• No infant walkers, No Johnny jumpers, No saucer chairs, and any other item that falls into that category are not permitted in the facility.

• The facility license number must be on all advertisements, publications, or announcements with the intent to attract clients.

• Isolation for ill children: When a child is ill, he/she shall be separated from other children (reference 102417(e) Operation of a Family Child Care Home).

• Liability Insurance was discussed; LPA advised applicant to review Title 22 Regulation 102417(m)(1) for additional information.

Inspection Authority: All adults living and working in the home shall be made of aware of the Departments right to inspection the home, which includes, but is not limited to the right to enter the home when children are being cared for, interview children and adults and review documentation.

Immunization Requirement: H&S 1597.622: Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. The applicant has proof of immunizations. Applicant understands that each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year and record must be kept of vaccine or declination letter.

Mandated Reporter Training: H&S 1596.8662: Beginning January 1, 2018, all licensed providers, applicants, directors, and employees to complete training as specified on mandated reporter duties. Mandated Reporter Training must be taken every two years. Training is available at: www.mandatedreporterca.com

Per applicant, she/he does not carry liability insurance or a bond in accordance with standard established by Family Child Care statue. Signed statements (LIC282) will be in children’s files. The law requires Family Child Care provider to carry liability insurance or bond in the amount of $300,000 annually or to maintain the signed statement in the facility file.

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NAME OF LICENSING PROGRAM MANAGER: Ana Chico
NAME OF LICENSING PROGRAM ANALYST: Veronica Martinez-Garza
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2026
LIC809 (FAS) - (06/04)
Page: 6 of 7
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: CUERVO & ESCAMILLA FAMILY CHILD CARE
FACILITY NUMBER: 198022162
VISIT DATE: 06/15/2026
NARRATIVE
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• Children and Staff records must be maintained and updated as needed and must be available for review by the Department.

LPA discussed the safe sleep regulations with applicants and discussed the Child Care Licensing Safe Sleep webpage at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep, as an additional resource. LPA also informed applicants of the importance of checking for and removing 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

Applicants were reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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 reviewed with applicants the LIC 311D, Forms/Records to Keep in your Family Child Care Home, children’s forms/records, facility forms/records, and information to be posted. Entrance Checklist was provided to the applicant.

On this date, 05/22/26, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

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NAME OF LICENSING PROGRAM MANAGER: Ana Chico
NAME OF LICENSING PROGRAM ANALYST: Veronica Martinez-Garza
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2026
LIC809 (FAS) - (06/04)
Page: 5 of 7
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: CUERVO & ESCAMILLA FAMILY CHILD CARE
FACILITY NUMBER: 198022162
VISIT DATE: 06/15/2026
NARRATIVE
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Because the applicants rent the home, proof of landlord notification is required. The rental agreement reflects 1 adult that does not live in the home and will not be present during hours of operation. Applicants provided a written declaration. The LPA observed the Property Owner/Landlord Notification form (LIC9151) that the applicant confirms was provided to the property owner/landlord. The applicant obtained a signed Property Owner/Landlord Consent form (LIC 9149).

A large family child care license will be granted upon receipt of proof of corrections for the above. Once licensed, the applicant is required to adhere to the terms and limitations stated on the license.

Once licensed, the applicants are required to adhere to the terms and limitations stated on the license.

The applicants signature on this report acknowledges that they have signed the Application for a Family Child Care Home License (LIC 279) under the penalty of perjury that the statements on the application and any attachments are correct.

A notice of site visit was given to applicants and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

Exit interview conducted and report was reviewed with the applicant Valentina Escamilla.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters, and other important information communication platforms.

To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

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NAME OF LICENSING PROGRAM MANAGER: Ana Chico
NAME OF LICENSING PROGRAM ANALYST: Veronica Martinez-Garza
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2026
LIC809 (FAS) - (06/04)
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