<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198003578
Report Date: 09/16/2019
Date Signed: 09/16/2019 03:05:41 PM

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:GU FAMILY CHILD CAREFACILITY NUMBER:
198003578
ADMINISTRATOR:GU, XIAOLINGFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 855-0598
CITY:HACIENDA HEIGHTSSTATE: CAZIP CODE:
91745
CAPACITY:14CENSUS: 0DATE:
09/16/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:38 PM
MET WITH:Qinglin XiaoTIME COMPLETED:
03:10 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Random inspection attempted. LPA met with licensee's spouse Qinglin Xiao. LPA was told that licensee is out picking up kids from school. He called licensee, and was informed that after licensee pick up the kids from school, she is taking them straight to tutoring center and probably won't be back until after 4 today.

Another inspection will be conducted.
SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 513-3793
LICENSING EVALUATOR NAME: Jennifer HuaTELEPHONE: (323) 981-3375
LICENSING EVALUATOR SIGNATURE:

DATE: 09/16/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 1