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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197493580
Report Date: 02/06/2020
Date Signed: 02/10/2020 08:42:32 AM

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:ALFASI FAMILY CHILD CAREFACILITY NUMBER:
197493580
ADMINISTRATOR:ELINOR ALFASIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 216-9561
CITY:NORTH HOLLYWOODSTATE: CAZIP CODE:
91606
CAPACITY:14CENSUS: 6DATE:
02/06/2020
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
01:55 PM
MET WITH:Elinor Alfasi/LicenseeTIME COMPLETED:
03:15 PM
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Licensing Program Analyst (LPA) Silva Garibyan visited the facility for the purpose of a Plan Of Correction (POC) visit. Licensee was present with six children ( including three infants) and two assistants. LPA met with the licensee and toured the home inside and outside at 02:00 p.m. on 02/06/2020. On the initial visit of 1/24/2020, the Licensee had 5 infants and 5 preschool age children in care. Licensee was cited for the following deficiencies:

1) Staffing Ratio and Capacity
2) Availability of information regarding detecting and reporting child abuse and neglect; training for mandated reporter who is licensed day care provider, administrator, or employee of a licensed child day care facility; proof of completion
3) Employees or volunteers at family day care home; immunization requirements; records; exemptions
Upon LPA arrival there were three infants and three preschool age children present. LPA observed the LIC 9224 ( Acknowledgement of Receipt of Licensing Reports) in the children's files. LPA also observed Licensee's Mandated Reporter training certificate ( assistants' English is limited) and Licensee's and assistants' immunization records.

On February 06, 2020 the facility has been found operating within substantial compliance per the California Health & Safety Code(s) and Title 22 Regulation(s).

A Copy of this Report and Notice of Site Visit were provided to the licensee.
An Exit interview was conducted.
SUPERVISOR'S NAME: Mary RuizTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Silva GaribyanTELEPHONE: (424) 301-3062
LICENSING EVALUATOR SIGNATURE:

DATE: 02/06/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2020
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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