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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198401341
Report Date: 09/24/2026
Date Signed: 09/24/2026 02:39:19 PM

Document Has Been Signed on 09/24/2026 02:39 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:VICENCIO FAMILY CHILD CAREFACILITY NUMBER:
198401341
ADMINISTRATOR/
DIRECTOR:		VICENCIO, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 445-1506
CITY:BELLFLOWERSTATE: CAZIP CODE:
90706
CAPACITY: 12TOTAL ENROLLED CHILDREN: 5CENSUS: 3DATE:
09/24/2026
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Licensee Maria VicencioTIME VISIT/
INSPECTION COMPLETED:
02:50 PM
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On September 24, 2026 at 1:00 p.m., Licensing Program Analyst (LPA) Peter Bishop arrived at the above facility to conduct a Case Management – Other inspection. Upon arrival LPA met with Licensee Maria Vicencio and was given a tour of the home. Per Licensee the hours of operation are Monday - Friday 7:00am to 5:00pm. She currently cares for infants - 12 years of age. At the time of this visit there were 3 children present and 5 children enrolled. This is a single story consisting of 2 bedrooms 1 bathroom, den, living room, dining room, kitchen and attached garage.

The purpose of this visit is to update the facility sketch and make the Den area of the home accessible to children. The Licensee is requesting to use the Den area for children to use. The only change is making the Den accessible to children. The 2 bedrooms, kitchen, attached garage will remain as the off-limits area. There is a baby gate at the entrance to the Den. There is also a door that leads directly to the outside play area. The Den area consists of two area rugs, a Peleton Stationary Bike. Licensee indicated that she will relocate the bike to an off limits area. The bike is not authorized to be in the Daycare area. LPA Bishop observed a cubby area with children’s toys and an Infant changing station in the room. LPA further observed other toys in the room that the children will use. LPA Bishop observed a mirror that sat on the floor. LPA observed the mirror to not be secure. Licensee indicated that she will have the mirror mounted to the wall will L brackets.

LPA Bishop informed Licensee that the following items must be done prior to the area being requested to use is approved. Peleton Bike must be removed , mirror must be mounted and photos sent to LPA once the corrections have been made. At this point the application will be reviewed. This area is not authorized to be used until it has been approved.

Exit interview was conducted with Licensee Maria Vicencio. A copy of this report has been provided to the Licensee. A Notice of Site Visit was given and must remain posted for 30 days.

Warren Birks
Peter Bishop
DATE: 09/24/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/24/2026
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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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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