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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191803046
Report Date: 07/08/2024
Date Signed: 07/08/2024 02:44:02 PM


Document Has Been Signed on 07/08/2024 02:44 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754



FACILITY NAME:LOS ANGELES FAMILY SCHOOLFACILITY NUMBER:
191803046
ADMINISTRATOR:LISSETT AVILAFACILITY TYPE:
850
ADDRESS:2646 GRIFFITH PARK BOULEVARDTELEPHONE:
(323) 663-8049
CITY:LOS ANGELESSTATE: CAZIP CODE:
90039
CAPACITY:92CENSUS: 65DATE:
07/08/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:35 PM
MET WITH:Lissett Avila, DirectorTIME COMPLETED:
03:10 PM
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On July 8, 2024, Licensing Program Analyst (LPA) Monique Ayala conducted an unannounced Case Management inspection for the above facility. A COVID-19 risk assessment was conducted prior to entering the facility. LPA met with director, Lissett Avila who guided LPA on a tour of the facility. LPA observed 65 children in care.

The purpose of the inspection is to follow up on an incident that occurred on 05/17/2024 and was reported to the department on 05/20/2024. The incident is a possible supervision violation.

During the inspection LPA interviewed Child #1 (C1), Staff #1 (S1) to Staff #2 (S2), LPA obtained photos and obtained a copy of the facilities roster.

At this time there are no deficiencies being cited. LPA reminded director that incidents need to be reported within 24 hours. LPA provided director with regulations for Supervision.

An exit interview was conducted and a copy of this report was provided to the director, Lissett Avila along with Appeal Rights. A Notice of Site Visit was provided and must be posted for 30 days.
SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Monique Jessica AyalaTELEPHONE: 323-981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 07/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/08/2024
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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