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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198012280
Report Date: 02/27/2020
Date Signed: 02/27/2020 11:41:43 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:HANNA FAMILY CHILD CAREFACILITY NUMBER:
198012280
ADMINISTRATOR:HANNA, JOSEFINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 924-0613
CITY:CERRITOSSTATE: CAZIP CODE:
90703
CAPACITY:14CENSUS: 10DATE:
02/27/2020
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Josefina Hanna, LicenseeTIME COMPLETED:
11:15 AM
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LPAs Lucero and Guzman conducted an unannounced Plan of Correction (POC) inspection to determine if the citation(s) cited on 02/21/2020 has been corrected.

The following citation(s) cited on 02/21/2020 has been corrected:

1. Criminal Record Clearance: LPA did not observe Edith Hernandez in the home. Licensee also submitted a statement to the department via fax that Edith Hernandez is no longer employed at the facility and will not be present in the facility until she has cleared fingerprinting.

On the date of this Plan of Correction inspection, LPA observed citation(s) mentioned above has been corrected.

Upon receipt of this report, the Licensee shall post the Notice of Site Visit and any Licensing report documenting a type “A” deficiency. The report and the Notice of Site Visit shall be posted for 30 consecutive days.

Exit interview, copy of report was given. Appeal rights were issued and discussed.
SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Armando J LuceroTELEPHONE: (323) 981-3435
LICENSING EVALUATOR SIGNATURE:

DATE: 02/27/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2020
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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