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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400298
Report Date: 08/22/2024
Date Signed: 08/22/2024 03:25:27 PM

Document Has Been Signed on 08/22/2024 03:25 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 SW RO, 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:
08/22/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:45 PM
MET WITH:Antonia Jimenez, LicenseeTIME VISIT/
INSPECTION COMPLETED:
03:45 PM
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Licensing Program Analysts (LPAs) Portia Bowden and Jeanette Estrada conducted an unannounced case management inspection to the above facility. LPAs met with Antonia Jimenez, Licensee and informed of the reason for the visit. LPAs inspected the home, there were 7 children present and two Adults

Also present during this inspection was Armando Jimenez, Licensee's adult son.

The licensee reported on 6/7/24 that an above ground pool will be installed in the backyard in area that is inaccessible to children in care. LPAs observed an above ground pool with no water in it (Bestway Pool Set 18 ft x 48 in.).

On 6/13/24 LPAs observed pool to not be barricaded, pool was not filled with water. On 6/27/24 LPAs observed a rod iron gate installed which did not meet requirements. On 7/3/24 LPAs observed wooden boards on windows facing pool area on utility porch adjacent to kitchen, inaccessibility on this date did not meet requirements.

During today's visit LPAs observed a mesh barrier surrounding pool that did not meet requirements. Mesh barrier does not have self latching door and is not 5 feet tall. Pool did not have water

Licensee stated pool will be removed from backyard and a photo will be provided to LPA.

LPAs discussed the requirements to having a pool on the premises. The licensee agrees not to fill the pool until the pool is removed. 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.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit made by a licensing representative.

Exit interview was conducted with Antonia Jimenez, Licensee, including, but not limited to Appeal Procedures, Site Visit and Initial Appeal Rights.

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Portia Bowden
LICENSING EVALUATOR SIGNATURE: DATE: 08/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/22/2024
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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