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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198011765
Report Date: 08/17/2021
Date Signed: 08/18/2021 08:00:18 AM

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:ANTONINI FAMILY CHILD CAREFACILITY NUMBER:
198011765
ADMINISTRATOR:ANTONINI, MARLAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 420-2396
CITY:LAKEWOODSTATE: CAZIP CODE:
90713
CAPACITY:14CENSUS: DATE:
08/17/2021
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
10:04 AM
MET WITH:Marla Antonini, LicenseeTIME COMPLETED:
11:05 AM
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An office meeting was conducted to address concerns pertaining to wearing face coverings as required by the California Department of Public Health Guidance issued July 17, 2020 and updated on June 29, 2021 and July 28, 2021.

Present at this meeting were Licensing Program Manager, Valarie Cook, Licensing Program Analyst, Alicia Mooberry and Licensee, Marla Antonini. Meeting took place via video conference using Microsoft Teams.

During the meeting the following was discussed:
· CDPH Guidance regarding face coverings
· CDSS enforcement role
· Inconsistencies that arise from changing guidance
· Licensee compliance history
· Relationship roles between enforcement agency and providers

Licensee agreed to comply with wearing a face covering while indoors with children regardless of vaccination status. Licensee also emphasized her willingness to comply with guidance enforced by CCLD and communicate any clarification needs to her LPA or LPM.

A copy of this report was sent to Marla Antonini via emailed
SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Alicia MooberryTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 08/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2021
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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