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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400618
Report Date: 10/15/2025
Date Signed: 10/15/2025 12:40:24 PM

Document Has Been Signed on 10/15/2025 12:40 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:WARREN FAMILY CHILD CAREFACILITY NUMBER:
198400618
ADMINISTRATOR/
DIRECTOR:		WARREN, RILEYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 220-5613
CITY:CARSONSTATE: CAZIP CODE:
90746
CAPACITY: 14TOTAL ENROLLED CHILDREN: 10CENSUS: 10DATE:
10/15/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:15 AM
MET WITH: Facility Representative Jennifer Warren.and Licensee Riley Warren TIME VISIT/
INSPECTION COMPLETED:
12:50 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) Ashley Calderon conducted an unannounced random/annual inspection. LPA met with Facility Representative Jennifer Warren. LPA disclosed the purpose of the inspection and was granted entry into the facility by Licensee.

At approx 9:55am Licensee Riley Warren arrived at the facility. Licensee conducted a tour of the facility alongside J.Warren and back yard tour was conducted with R.Warren. During today's visit there were 10 children present (4 whom were infants). Facility capacity is in compliance for a Large Family Child Care Home- Capacity 14. Per Licensee, hours of operation are Monday through Sunday from 12:00AM to 11:59PM , currently children being cared for overnight care and LPA's informed Licensee care cannot exceed 24 hour care at one time. Licensee care for children Infants -12 years of age.

This is a two story home. The home consists of 4 bedrooms, 3 restrooms, living room, kitchen, day care room, backyard, garage, and front yard. Areas that are accessible to children include: one bathroom, day care room, part of the living room, and backyard. Areas off limits to children and parents include: All bedrooms upstairs (4) and bathrooms (2), kitchen, half of the living room, garage, and front yard.

Inside and outside of the home has age appropriate children materials, toys and equipment. LPA observed in the front yard fountain and a pond, that did not have running water. Fountain Pond was empty and covered with a net, fountain-pond measures at 3ft. 8 inches wide and .8 inches deep.

Areas used by children were inspected for safety, comfort, heating, cleanliness and telephone service. The home has central air and heating. (Page 1/ Continuation...)
NAME OF LICENSING PROGRAM MANAGER: Denise Gibbs
NAME OF LICENSING PROGRAM ANALYST: Ashley Calderon
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 10/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/15/2025
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)
Page: 2 of 7
Document Has Been Signed on 10/15/2025 12:40 PM - It Cannot Be Edited


Created By: Ashley Calderon On 10/15/2025 at 11:17 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: WARREN FAMILY CHILD CARE
FACILITY NUMBER: 198400618

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/15/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102425(a)(3)
Infant Safe Sleep
(a) There shall be one crib or play yard for each infant who is unable to climb out of the crib or play yard. (3) Mattresses shall be firm and covered with a fitted sheet that is appropriate to the mattress size, fits tightly on the mattress, and overlaps the underside of the mattress so it cannot be dislodged.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on LPA Calderon's observation (3) Play yards and (1) crib for infants in care, LPA touched mattresses and they were pads or toppers and not firm mattress and (2) play yards and sheets that dislodged, LPA informed Licensee not having appropriate mattresses per Title 22 and not having fitted sheets can lead suffocation and can lead to Sudden Infant Death Syndrome(SIDS), pictures taken, the licensee did not comply with the section cited above in [1] out of [4] matress which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 10/16/2025
Plan of Correction
1
2
3
4
Per Lciensee, will purchase firm mattress and fitted sheets and send pictures to LPA Calderon by POC due date.
Type A
Section Cited
CCR
102417(g)
All licensees shall ensure the inaccessibility of pools (in-ground and above-ground), fixed-in-place wading pools, hot tubs, spas, fish ponds and similar bodies of water through a pool cover or by surrounding the pool with a fence.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on back yard observation by LPA Calderon, back yard has play area is next to the jacuzzi, Per Licensee R.Warren stated children play in the back yard and jacuzzi was observed with (4) latches that was tested for inaccessbility LPA Calderon pushed button on latch inwards and pulled up which opens the latch to access the cover and cover that mets ASTM F1346-1991 can be lifted, jacuzzi was observed to have water, pictures taken, the licensee did not comply with the section cited above in [1] out of [1] jacuzzi which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 10/16/2025
Plan of Correction
1
2
3
4
Per Licensee, will have a contrator add locks to the latches on the jacuzzi and send picture to LPA Calderon by poc due date.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Denise Gibbs
NAME OF LICENSING PROGRAM MANAGER:
Ashley Calderon
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 10/15/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/15/2025


LIC809 (FAS) - (06/04)
Page: 3 of 7
Document Has Been Signed on 10/15/2025 12:40 PM - It Cannot Be Edited


Created By: Ashley Calderon On 10/15/2025 at 11:17 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: WARREN FAMILY CHILD CARE
FACILITY NUMBER: 198400618

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/15/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.622(a)(1)
General Provisions and Definitions
(1) 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. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review BY LPA Calderon; Volunteer present at the home had no file and no immunization records, LPA informed Licensee when volunteers are present they shall not exceed 16 hours a week and must not be left alone with children and Staff Assistant #2 present file was reviewed, Staff Assistant #2 did not have Tuberculosis vaccination record, the licensee did not comply with the section cited above in [1] out of [1] incompletion immunization records which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/03/2025
Plan of Correction
1
2
3
4
If Volunteer continues to assist at the facility immunization record needed MMR, TDAP, TB(current) and Flu (get or decline letter) records and Staff Assistant #2 - TB records send copies to LPA Calderon by POC due date.
Type B
Section Cited
CCR
102425(j)(2)(D)
Infant Safe Sleep
Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following:

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on records review conducted by LPA Calderon Infants Child #1, Child #2 and Child #3 did not have 15 min sleep log; Per Licensee, thought sleep log was for children 0-1 year old; therefore, it was observed at 10:31am that only Child #4 had 15 min sleep log, picture taken, the licensee did not comply with the section cited above in [3] out of [4] infant 15 min sleep log which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/24/2025
Plan of Correction
1
2
3
4
Licensee will start sleep log for Infants Child #1, Child #2 and Child #3 and send copies to LPA Calderon by poc due date.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Denise Gibbs
NAME OF LICENSING PROGRAM MANAGER:
Ashley Calderon
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 10/15/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/15/2025


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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: WARREN FAMILY CHILD CARE
FACILITY NUMBER: 198400618
VISIT DATE: 10/15/2025
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
Kitchen was observed. Per Licensee, provides food for children in care. Knives and sharps are located in a cabinet on the island table and there is a baby safety gate at the entrance of the kitchen and there is a large/big couch blocking access to part of the living room that connects to the kitchen. The section of the living room that is used at the day care, is used for infants naps. In the kitchen there is a staircase, there is a wooden gate to block of staircase, LPA consulted on securely providing inaccessibility to the staircase by latching the wooden gate to the wall/staircase.

LPA Calderon observed (3) Play yards and (1) crib for infants in care, LPA touched mattresses and they were pads or toppers and not firm mattress and (2) play yards and sheets that dislodged, LPA informed Licensee not having appropriate mattresses per Title 22 and not having fitted sheets can lead suffocation and can lead to Sudden Infant Death Syndrome(SIDS), pictures taken and deficiency cited.

Based on back yard observation by LPA Calderon, back yard has play area is next to the jacuzzi at 10:03am, Per Licensee R.Warren stated children play in the back yard and jacuzzi was observed with (4) latches that was tested for inaccessibility LPA Calderon pushed button on latch inwards and pulled up which opens the latch and access the jacuzzi, the cover that mets ASTM F1346-1991 , that can be lifted and jacuzzi was observed to have water, pictures taken and deficiency cited.

During record review Volunteer present at the home had no file and no immunization records, LPA informed Licensee when volunteers are present they shall not exceed 16 hours a week and must not be left alone with children and Staff Assistant #2 present file was reviewed, Staff Assistant #2 did not have Tuberculosis vaccination record, deficiency cited. Licensee and staff assistant #1 had all appropriate documentation's; Licensees Pediatric 1st aid and cpr expires 5/2026 / Mandated Reporter expires 5/01/26. Children records were reviewed; consultation was given on immunization document CDPH/PM 286 and consultation given for any child under the age of 6 and enrolled in a school to have verification of enrollment. Infants Child #1, Child #2 and Child #3 did not have 15 min sleep log; Per Licensee, thought sleep log was for children 0M-1 year old; therefore, it was observed at 10:31am that only Child #4 had 15 min sleep log only, picture taken, deficiency cited.

(Pg 2 / Cont...)
NAME OF LICENSING PROGRAM MANAGER: Denise Gibbs
NAME OF LICENSING PROGRAM ANALYST: Ashley Calderon
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2025
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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: WARREN FAMILY CHILD CARE
FACILITY NUMBER: 198400618
VISIT DATE: 10/15/2025
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
Fire extinguisher was observed with receipt date purchased 6/4/25. Disaster and Fire Drill was last conducted on 10/8/2025. LPA observed a barricaded fireplace in the day care room. Per Licensee, no Firearms/guns stored in the home. Per licensee, no children on medication.
  • To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.
  • 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 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 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 child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California. (Pg 3/ Cont...)
NAME OF LICENSING PROGRAM MANAGER: Denise Gibbs
NAME OF LICENSING PROGRAM ANALYST: Ashley Calderon
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2025
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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: WARREN FAMILY CHILD CARE
FACILITY NUMBER: 198400618
VISIT DATE: 10/15/2025
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
A copy of this report dated 10/15/25, the document(s) of (2) Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Ashley Calderon informed the licensee Riley Warren to provide a copy of this licensing report dated 10/15/25 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report.

The Acknowledgement form must be maintained in each child’s file immediately upon receipt from parent. Licensee was provided with a copy of the parent Acknowledgement of Receipt of Licensing Reports Form during this visit.

A Notice of Site visit was given and must be posted for 30 days. Exit interview conducted with Licensee Riley Warren.

NAME OF LICENSING PROGRAM MANAGER: Denise Gibbs
NAME OF LICENSING PROGRAM ANALYST: Ashley Calderon
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2025
LIC809 (FAS) - (06/04)
Page: 7 of 7