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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198015299
Report Date: 07/11/2023
Date Signed: 07/11/2023 01:10:54 PM


Document Has Been Signed on 07/11/2023 01:10 PM - It Cannot Be Edited

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:YMCA GLB PLAY & LEARN PRESCHOOLFACILITY NUMBER:
198015299
ADMINISTRATOR:MONA ASADFACILITY TYPE:
850
ADDRESS:2179 PACIFIC AVENUETELEPHONE:
(562) 218-4693
CITY:LONG BEACHSTATE: CAZIP CODE:
90806
CAPACITY:104CENSUS: DATE:
07/11/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:55 PM
MET WITH:Natalie Ugalde, Site DirectorTIME COMPLETED:
01:20 PM
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LPA Chambers stopped to meet the new Site Director and collect the Directors Package. The facility was not due for the annual inspection yet.
SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Dayna ChambersTELEPHONE: (323) 558-2962
LICENSING EVALUATOR SIGNATURE:
DATE: 07/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/11/2023
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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