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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197493338
Report Date: 02/11/2020
Date Signed: 02/11/2020 11:31:37 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:MAJUAN FAMILY CHILD CAREFACILITY NUMBER:
197493338
ADMINISTRATOR:MAJUAN, LEYANISFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 220-0131
CITY:SYLMARSTATE: CAZIP CODE:
91342
CAPACITY:14CENSUS: 11DATE:
02/11/2020
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Leyanis MajuanTIME COMPLETED:
11:40 AM
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Licensing Program Analysts (LPAs) King and Ayala conducted an unannounced case management to the facility above, for the purpose of following up on an unusual incident report. Involving 2 children playing with an umbrella and one of the children getting injured.

During the inspection LPA's toured the facility. LPAs interviewed licensee, licensee's assistants and three children. A copy of children's roster was emailed to LPAs.. The interviews did not indication the facility did not provide supervision for the children in care. There were three staff in play area positioned throughout the play area providing care. LPAs observation of staff and children the day of this visit show how staff inter acts with the children and the children did not appear to be interested in going into the cabinet stored in the play area .

Based on the information obtained the incident that occurred 02/04/2020 was not a result of lack of care and supervision.

An exit interview was conduct and a copy of this report and Notice of Sit Visit was given to licensee.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Lady KingTELEPHONE: (661) 568-8933
LICENSING EVALUATOR SIGNATURE:

DATE: 02/11/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2020
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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