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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191801302
Report Date: 05/03/2022
Date Signed: 05/03/2022 01:24:43 PM


Document Has Been Signed on 05/03/2022 01:24 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754



FACILITY NAME:CHILDTIME CHILDRENS'S CENTERFACILITY NUMBER:
191801302
ADMINISTRATOR:ANA FRAGOSO-TOVALINFACILITY TYPE:
830
ADDRESS:4820 S. EASTERN AVE. SUITE #FTELEPHONE:
(323) 721-0552
CITY:LOS ANGELESSTATE: CAZIP CODE:
90040
CAPACITY:24CENSUS: 17DATE:
05/03/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:43 PM
MET WITH:Director Ana FragosoTIME COMPLETED:
01:40 PM
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On 5/3/22 Licensing Program Analyst (LPA) conducted an unannounced Case-Management visit for the purpose of obtaining signatures and delivering an amended report. LPA met with Director, Ana Fragoso and informed her of the reason for the visit. There were 17 children present when LPA arrived-8 infants with 2 teachers and 9 napping toddlers with 1 teacher.

A notice of site visit was given and must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the Director, Ana Fragoso Tovalin.

SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 513-3828
LICENSING EVALUATOR NAME: Jeanette EstradaTELEPHONE: (323) 229-6521
LICENSING EVALUATOR SIGNATURE:
DATE: 05/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/03/2022
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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