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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197493287
Report Date: 10/01/2019
Date Signed: 10/01/2019 09:52:53 AM

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:URIZAR FAMILY CHILD CAREFACILITY NUMBER:
197493287
ADMINISTRATOR:URIZAR, SANDRAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 815-5336
CITY:LOS ANGELESSTATE: CAZIP CODE:
90062
CAPACITY:14CENSUS: 5DATE:
10/01/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:31 AM
MET WITH:Sandra Urizar TIME COMPLETED:
10:05 AM
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Licensing Program Analyst, Judy Mora conducted an unannounced Case Management- Other inspection today. Visit was conducted in Spanish. Present at the facility is licensee, Sandra Urizar. LPA observed 5 children during today's visit.

The deficiencies cited on 08/21/19 have been corrected. LPA observed and reviewed the following:
  • LPA observed files for children enrolled.
  • LPA observed a complete and current roster.

Letter of Deficiency of Citations Cleared issued to Licensee.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing reprehensive. Failure to maintain posting as required will result in a civil penalty of $100.00.

Exit interview was conducted with Licensee. Appeal Rights procedures distributed and explained.
SUPERVISOR'S NAME: Katherine HarewoodTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Judy MoraTELEPHONE: (323) 981-3371
LICENSING EVALUATOR SIGNATURE:

DATE: 10/01/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/01/2019
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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