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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198007112
Report Date: 01/16/2020
Date Signed: 01/16/2020 03:46:39 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:TERRY FAMILY CHILD CAREFACILITY NUMBER:
198007112
ADMINISTRATOR:TERRY, JUDY DARLENEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 431-7471
CITY:LONG BEACHSTATE: CAZIP CODE:
90815
CAPACITY:14CENSUS: 7DATE:
01/16/2020
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
03:15 PM
MET WITH:Judy TerryTIME COMPLETED:
04:01 PM
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A Plan of Corrections inspection was conducted by Licensing Program Analyst Timothy Fields for the purpose following up on the following deficiencies cited on 01/07/20:
  1. 102370 (d)(1) Criminal Record Clearance.
  2. 102416(c) Personnel Requirement.
  3. 102417(g) Operations of a Child Care Home.


Assistant Devon Zoriki has obtained a criminal record clearance and valid CPR/First Aid certification (expiration date 1/11/22). There were no baby bouncers or saucers chairs observed in the home. Licensee is now in compliance with the above regulations. There seven day care children in care upon arrival.

Exit interview conducted with licensee. Appeal Rights provided and explained. Notice of Site Visit must be posted for (30) days. Failure to do so may result in a $100.00 civil penalty.
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Timothy FieldsTELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:

DATE: 01/16/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2020
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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