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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191596580
Report Date: 02/12/2020
Date Signed: 02/12/2020 03:38:09 PM

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:MARYVALE DAY CARE CENTERFACILITY NUMBER:
191596580
ADMINISTRATOR:JESSICA LIRAFACILITY TYPE:
830
ADDRESS:7600 E. GRAVES AVENUETELEPHONE:
(626) 280-6510
CITY:ROSEMEADSTATE: CAZIP CODE:
91770
CAPACITY:40CENSUS: 27DATE:
02/12/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Christina MooreTIME COMPLETED:
03:45 PM
NARRATIVE
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Licensing Program Analyst (LPA) Seung Lee conducted an unannounced case management inspection. Upon arrival LPA Lee met with Director Christina Moore.

The purpose of the inspection was to obtain additional information regarding a pending update application. The facility currently serves 32 infants and 8 toddlers. The facility requested to serve 28 infants and 12 toddlers.

LPA Lee observed that the toddler yard measured out for a total of 17 children while the indoor room measured out for a total of 11 children. The measurements done during this inspection matched the numbers from the previous inspection's measurements.

Since the indoor space for toddlers is 11, the facility stated a new application will be submitted to the department requesting to serve 29 infants and 11 toddlers.

LPA Lee advised the facility that a new waiver letter will need to granted prior to the update application being granted.

The notice of site inspection must remain posted for a period of 30 days during hours of operation. Failure to maintain posting will result in a civil penalty of $100.00 dollars.

Exit interview conducted with Director Christina Moore. Appeal rights discussed and explained.
SUPERVISOR'S NAME: Guangorena ClaudiaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Seung LeeTELEPHONE: (323) 981-3382
LICENSING EVALUATOR SIGNATURE:

DATE: 02/12/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2020
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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