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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198005398
Report Date: 02/19/2020
Date Signed: 02/19/2020 03:45:43 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:LEON FAMILY CHILD CAREFACILITY NUMBER:
198005398
ADMINISTRATOR:AIDA LEONFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 925-3365
CITY:BELLFLOWERSTATE: CAZIP CODE:
90706
CAPACITY:14CENSUS: 4DATE:
02/19/2020
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Aida LeonTIME COMPLETED:
04:00 PM
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Licensing Program Analysts (LPA) Elka Chavez conducted an announced case management inspection. The purpose of today's visit is to provide the Licensee an amended report to correct signatures and add signatures.

The Licensee was reminded to adhere to Title 22 regulations and the restrictions of the license
Upon receipt the Licensee shall post the Notice of Site Visit and the Licensing Report. This report and the Notice of Site Visit shall be posted for 30 consecutive days. Failure to maintain posting as required will result in a $100.00 civil penalty. Exit interview conducted with License Aida Leon.
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Elka ChavezTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 02/19/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/19/2020
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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