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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198007536
Report Date: 10/24/2019
Date Signed: 10/24/2019 08:31:21 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:CHILDREN'S COLLECTIVE, INC./MC ALISTER INFANT, THEFACILITY NUMBER:
198007536
ADMINISTRATOR:JEANNETTE BANUELOSFACILITY TYPE:
830
ADDRESS:4525 PINAFORE ST.TELEPHONE:
(323) 481-4423
CITY:LOS ANGELESSTATE: CAZIP CODE:
90008
CAPACITY:17CENSUS: 6DATE:
10/24/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
07:00 AM
MET WITH:Jeannette BanuelosTIME COMPLETED:
08:40 AM
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
On 10/24/19, Licensing Program Analyst (LPA) Karren Starks made an unannounced visit for the purpose of conducting a Case Management inspection due to the receipt of a Case Closure notification from CBCB. LPA observed the Director and 1 TA, Irma Cruz with two infants in care initially with additional children arriving during visit

LPA received the notification dated 10/14/19 advising that the case for GABRIELA GARCIA had been closed. The Department has ceased processing the background check for this individual and closed the case.. An exemption was not requested for this individual, nor the documents submitted within the time-frame.

This individual was not observed to be at the facility during the time of visit, nor was the Director aware of the individual.

A copy of the Case Closure was given to the Director.

No deficiency cited.

Copy of report and Notice of Site visit issued.
SUPERVISOR'S NAME: Jennie FerreiraTELEPHONE: (424) 301-3067
LICENSING EVALUATOR NAME: Karren StarksTELEPHONE: (424) 301-3069
LICENSING EVALUATOR SIGNATURE:

DATE: 10/24/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2019
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