Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198016467
Report Date: 01/26/2017
Date Signed: 01/26/2017 09:04:48 AM

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:MEDRANO & AGUIRRE FAMILY CHILD CAREFACILITY NUMBER:
198016467
ADMINISTRATOR:MEDRANO, M & AGUIRRE, WFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 699-2549
CITY:WHITTIERSTATE: CAZIP CODE:
90606
CAPACITY:14CENSUS: 8DATE:
01/26/2017
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Marlen Medrano & Zoila CastilloTIME COMPLETED:
09:10 AM
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Plan of Correction inspection conducted by LPAs Jennifer Hua & Raul Navarro. The purpose of this inspection is to follow up on the deficiency cited on 1/17/17. LPAs met with licensee, Marlen Medrano. LPAs observed 8 children with 1 infant in care supervised by licensee and her assistant Zoila Castillo (mother-in-law) Licensee is Spanish speaking. LPA Raul Navarro translated during this visit. LPAs reviewed children's roster and observed 13 children enrolled. Per licensee, she has 13 children enrolled. LPAs also observed Notice of Site Visit form is posted along with the type A citation report. LPAs also observed form LIC 9224 have been completed and signed. Assistant Jessica Huerta arrived during visit.

Based on reviews and observation today, deficiency is corrected at this time.

An exit interview conducted, copy of report given. Notice of Site Visit form was provided and explained.
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Jennifer HuaTELEPHONE: (323) 854-6738
LICENSING EVALUATOR SIGNATURE:

DATE: 01/26/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2017
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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