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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400298
Report Date: 06/27/2024
Date Signed: 06/27/2024 02:52:16 PM

Document Has Been Signed on 06/27/2024 02:52 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:JIMENEZ FAMILY CHILD CAREFACILITY NUMBER:
198400298
ADMINISTRATOR/
DIRECTOR:		ANTONIA JIMENEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 740-6168
CITY:COMPTONSTATE: CAZIP CODE:
90220
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 7DATE:
06/27/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:45 PM
MET WITH:Antonia Jimenez, LicenseeTIME VISIT/
INSPECTION COMPLETED:
03:15 PM
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Licensing Program Analysts (LPAs) Alicia Mooberry and Portia Bowden conducted an unannounced case management inspection to the above facility to follow up on incident reported by licensee, facility is adding an above ground pool. LPAs met with licensee, Antonia Jimenez and informed of the reason for the visit. LPAs inspected the home, there were seven (7) children present including one napping infant, Child #1 age 9 months was observed sleeping in play yard. LPA's reminded licensee to follow Safe Sleep Regulations PIN 20-24-CCP.

LPA's inspected the home and the back yard where licensee wishes to install an above ground pool. LPAs observed the empty pool (18 ft x 48 in.). LPAs observed black steel fence is being installed between the yard where the pool is located and the back door exit to the home.

LPAs provided Technical Assistant and reviewed California Code of Regulations 102417(g)(5)(A(B) that requires licensee to ensure inaccessibility of pools or any such body of water to children in care.

The licensee agrees NOT to fill the pool until the family has installed the required barriers. LPAs will conduct a follow up visit to ensure the health and safety of children in care and to ensure that Licensee is in compliance.

No deficiencies are cited during this inspection.

The Notice of Site Visit (LIC 9213) was given and must remain posted for 30 days.

Exit interview was conducted with Antonia Jimenez, Licensee.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE: DATE: 06/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/27/2024
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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