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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191597832
Report Date: 12/16/2019
Date Signed: 12/16/2019 09:30:06 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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:MAOF CHILD CARE CENTER - DOWNEYFACILITY NUMBER:
191597832
ADMINISTRATOR:ARACELY GARCIAFACILITY TYPE:
850
ADDRESS:8100 TELEGRAPH ROADTELEPHONE:
(562) 806-5054
CITY:DOWNEYSTATE: CAZIP CODE:
90240
CAPACITY:80CENSUS: 43DATE:
12/16/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:10 AM
MET WITH:SupervisorTIME COMPLETED:
09:40 AM
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Licensing Program Analyst (LPA) Tiffanie Tran arrived at MAOF Child Care Center- Downey to conduct a case management inspection to deliver an immediate action required for Elizabeth Moreno. Upon arrival, LPA met with Supervisor and about 8:30 a.m. we toured the facility. LPA observed proper care and supervision during this inspection. All center staff that was present during today’s inspection had fingerprint cleared and associated to the designated license number.

Based on evidence obtained during today’s inspection, LPA has verified the individual is not present at the facility. Per staff stated, the mentioned name was never employee at this facility. A copy of the case closure was given to Supervisor and Human Resources. LPA obtained the completion action request form and LIC 500.

An exit interview conducted. This copy was provided to the noted person.
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Tiffanie TranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2019
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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