<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400361
Report Date: 05/05/2023
Date Signed: 05/05/2023 03:34:27 PM

Document Has Been Signed on 05/05/2023 03:34 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 S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:ZELAYA FAMILY CHILD CAREFACILITY NUMBER:
198400361
ADMINISTRATOR:ZELAYA-GARCIA, KARLAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 284-9606
CITY:LONG BEACHSTATE: CAZIP CODE:
90805
CAPACITY: 14TOTAL ENROLLED CHILDREN: 11CENSUS: 5DATE:
05/05/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:40 PM
MET WITH:Licensee - Karla ZelayaTIME COMPLETED:
03:50 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) R. Derraco conducted an unannounced case management visit on 05/05/23 to the above mentioned address. LPA arrived at the facility at 2:40 PM and was met by licensee, Karla Zelaya who provided a tour of the facility. Also present during this visit was assistant S2. LPA observed 5 children in care. LPA observe the home to be clean and free of defects. The bathroom designated for children in care was observed to be clean with an operable sink, faucet, and toilet. LPA observed day care items to be moved into the shaded area of the outdoor space. Licensee states that due to the recent rain storms, the items have been temporarily moved under the shade to avoid water damage caused by the rain.

The purpose of this visit is to observe an activity space that was previously off limits for use by children in care. LPA observed the activity space to be located in the detached garage. One door was observed leading into the garage. Per licensee, she plans to keep the main garage door closed at all times. LPA observed a desk, a desktop computer with monitor, office chair, a children's rug, a book rack with children's reading material and a child sized couch. Licensee states that she will provide a portable plug-in air conditioning unit during warm days the activity space is in use. LPA did not observe any objects in the detached garage that can pose a danger to children in care.

LPA advised the following to the licensee when using the detached garage as an activity space:
-Children in care CANNOT nap or take meals in the detached garage
-Portable heating and air conditioning appliances must be made inaccessible to children in care
-While children are using the detached garage as an activity space, one or both doors are to remain open while in use
-Children in care must be supervised at all times while they are in the activity space, indoors in the main care area or in the outdoor play area.

(page 1 of 2)
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE: DATE: 05/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/05/2023
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 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: ZELAYA FAMILY CHILD CARE
FACILITY NUMBER: 198400361
VISIT DATE: 05/05/2023
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
LPA R. Derraco concludes that the home is in compliance with Title 22 regulations. The detached garage is observed to be ready to use by the licensee as an activity space for children in care.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the licensee Karla Zelaya.

(page 2 of 2)
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:

DATE: 05/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2023
LIC809 (FAS) - (06/04)
Page: 2 of 2