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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197419750
Report Date: 07/29/2021
Date Signed: 07/29/2021 02:13:16 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:LEWIS FAMILY CHILD CAREFACILITY NUMBER:
197419750
ADMINISTRATOR:LEWIS, MINERVAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 406-7991
CITY:GRANADA HILLSSTATE: CAZIP CODE:
91344
CAPACITY:14CENSUS: DATE:
07/29/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:26 PM
MET WITH:TIME COMPLETED:
02:01 PM
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On 07/29/2021 at 1:26pm Licensing Program Analyst (LPA) Laticia Thompson attempted to conduct an Annual Inspection at Lewis Family Child Care Home. LPA knocked at front door and rung door bell several times no answer. LPA called facility number and reached recording that states the subscriber is not accepting calls at this time. LPA conducted a walk around of the facility, LPA also conduct a walk around of facility and did not hear any activity of children or adults.

LPA called alternate phone number located on sign in front of facility no answer and number is not accepting voicemail.
SUPERVISOR'S NAME: Peter FloresTELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Laticia S ThompsonTELEPHONE: (424) 301-3048
LICENSING EVALUATOR SIGNATURE:

DATE: 07/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2021
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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