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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198014905
Report Date: 01/30/2020
Date Signed: 01/30/2020 04:50:09 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:CARDONA FAMILY CHILD CAREFACILITY NUMBER:
198014905
ADMINISTRATOR:JUAN CARDONAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 587-8766
CITY:HUNTINGTON PARKSTATE: CAZIP CODE:
90255
CAPACITY:14CENSUS: 12DATE:
01/30/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:20 PM
MET WITH:Juan Cardona, LicenseeTIME COMPLETED:
05:00 PM
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Inspection Conducted in Spanish
Licensing Program Analyst (LPA) Alicia Mooberry arrived at the facility for the purpose of following up on a change to application. Licensee requested to add daughter Karina Cardona as co-licensee. Upon arrival, LPA was met by Ivon Angulo, licensee's assistant. Juan Cardona was present and there were 12 children in care. A copy of children's roster reviewed.
Per licensee, Karina will not be able to complete the requirement to be added to license until after March of 2020 due to health reasons.
Per licensee, Juan Cardona Jr. does not live in the home and will not be present in the home until he is fingerprint cleared (declaration received).

Exit interview conducted with Juan Cardona, licensee a copy of this report was given to licensee
SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Alicia MooberryTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 01/30/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/30/2020
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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