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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197416779
Report Date: 02/15/2022
Date Signed: 02/15/2022 01:42:45 PM


Document Has Been Signed on 02/15/2022 01:42 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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245



FACILITY NAME:CASTLE IN THE CLOUDSFACILITY NUMBER:
197416779
ADMINISTRATOR:LEE, KYE J.FACILITY TYPE:
850
ADDRESS:1435 W. 120TH STREETTELEPHONE:
(323) 756-9191
CITY:LOS ANGELESSTATE: CAZIP CODE:
90047
CAPACITY:50CENSUS: 18DATE:
02/15/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:31 PM
MET WITH:Kye Lee, DirectorTIME COMPLETED:
01:45 PM
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On 2/15/22 at 1:31pm, LPA Risher conducted a case management visit to obtain a signature for an amended report. LPA met with Kye Lee, Director and provided the purpose of the visit. LPA observed 18 children in care with 2 staff

LPA made corrections to the original report. LPA Risher provided a copy of the amended report to the Director

An exit interview was conducted, and appeal rights were provided.

SUPERVISOR'S NAME: Maureen NealTELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Adrian RisherTELEPHONE: (424) 301-3050
LICENSING EVALUATOR SIGNATURE:
DATE: 02/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/15/2022
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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