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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197410108
Report Date: 11/15/2019
Date Signed: 11/15/2019 02:48:52 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:ESTRADA FAMILY CHILD CAREFACILITY NUMBER:
197410108
ADMINISTRATOR:ESTRADA, MARTHAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 793-0154
CITY:LAWNDALESTATE: CAZIP CODE:
90260
CAPACITY:14CENSUS: DATE:
11/15/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Martha EstradaTIME COMPLETED:
01:25 PM
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Licensing Program Analyst’s (LPA’s) Antonio Almanza and Adrian Risher is conducting a case management visit to determine the operational status of the Carter Family Day Care. Correspondence notifying the licensee past due fees was sent on 08/12/19, and no reply, or payment of fees was submitted to CCLD. A forfeiture notice was sent to licensee on 10/22/19 advising the license is forfeit by operation of law.

On today, 11/15/19, LPA’s Antonio Almanza, attempted contact at the facility address to determine if children are in care, and the disposition of the facility. Upon entering the home, LPA’s observed 10 children in care and 2 adults. LPA’s notified the Licensee the reason for the unannounced visit. The Licensee stated that she had copies of payments. The licensee stated that she received Forfeiture Letter in the mail and mailed proof of payment to Sacramento.

Licensee stated that she has changed her phone number and provided LPA’s with written notice to change her phone number to (

LPA’s where provided copies of pay checks.

An exit interview was conducted. A copy of report and notice of site visit was furnished to Licensee.

SUPERVISOR'S NAME: Victor BautistaTELEPHONE: (424) 301-3008
LICENSING EVALUATOR NAME: Antonio AlmanzaTELEPHONE: (424) 301-3057
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2019
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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