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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198004537
Report Date: 09/19/2019
Date Signed: 09/19/2019 01:21:26 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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:BELLFLOWER USD-WILLIAMS CHILD CARE CENTERFACILITY NUMBER:
198004537
ADMINISTRATOR:KEISHA SAWYERFACILITY TYPE:
850
ADDRESS:6144 CLARKTELEPHONE:
(562) 461-7192
CITY:LAKEWOODSTATE: CAZIP CODE:
90712
CAPACITY:20CENSUS: 0DATE:
09/19/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Supervisor TIME COMPLETED:
01:40 PM
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Licensing Program Analyst (LPA) Tiffanie Tran arrived at Bellflower USD- Williams CHild Care Center located at 6144 Clark, Lakewood, CA 90712 to conduct an unannounced case management inspection for the purpose of temporary usage room 14 on the same premises due to the licensed bungalow has termite damage that cannot be fixed during this time and in the process of replacement new bungalow.

Upon arrival, LPA met with Supervisor and tour the temporary usage room 14. The facility had sufficiency indoor/outdoor space and children's restrooms to accommodate 20 ages 2-5 years old. The facility is sharing the Kindergarten outdoor yard. LPA reminds, there shall be no commingling between the two programs at any times. Direct adults’ supervision is required at all time during outdoor play.

It's the facility responsibility to report to the licensing department upon any chances to the child care operation and update of the replacement of the old bungalow.

No deficiency was found during today’s visit. The copy of this report was provided to the noted person.

SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Tiffanie TranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2019
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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