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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198005504
Report Date: 08/10/2022
Date Signed: 08/10/2022 11:06:41 AM


Document Has Been Signed on 08/10/2022 11:06 AM - It Cannot Be Edited

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:BACHES FAMILY CHILD CAREFACILITY NUMBER:
198005504
ADMINISTRATOR:BACHES, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 943-8712
CITY:ALHAMBRASTATE: CAZIP CODE:
91801
CAPACITY:14CENSUS: 9DATE:
08/10/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Maria BachesTIME COMPLETED:
11:15 AM
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Licensing Program Analyst (LPA) Seung Lee conducted an unannounced case management inspection. Upon arrival LPA Lee met with Licensee Maria Baches.

The purpose of the inspection was to obtain the Licensee's signature for an amended report dated 07/18/2022. The amendment of the previous report was explained to the Licensee during the inspection.

The notice of site inspection must remain posted for a period of 30 days during hours of operation. Failure to maintain posting will result in a civil penalty of $100.00 dollars.

Exit interview conducted with Licensee Maria Baches. Appeal rights discussed and explained.
SUPERVISOR'S NAME: Guangorena ClaudiaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Seung LeeTELEPHONE: (323) 981-3382
LICENSING EVALUATOR SIGNATURE:
DATE: 08/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/10/2022
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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