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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198015658
Report Date: 12/13/2019
Date Signed: 12/13/2019 03:37:54 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:UNION PACIFIC CDC/YWCA OF GREATER L.A.FACILITY NUMBER:
198015658
ADMINISTRATOR:NORMA GONZALEZFACILITY TYPE:
830
ADDRESS:4315 UNION PACIFIC AVENUETELEPHONE:
3234156057
CITY:LOS ANGELESSTATE: CAZIP CODE:
90023
CAPACITY:38CENSUS: 52DATE:
12/13/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:35 PM
MET WITH:Adriana Lopez_DirectorTIME COMPLETED:
03:35 PM
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Licensing Program Analyst (LPA) Reiko Jones-Modeste conducted an unannounced Case Management visit to Amend a previous report dated November 19, 2019. LPA met with Director Adriana Alvarado who guided LPA on a tour of the facility. LPA observed 52 children in care with 12 teachers present. Facility is in compliance surrounding capacity and ratio.

LPA observed two unassociated adults providing care to children on November 19, 2019.

At 4:10pm on November 19, 2019 LPA confirmed the following staff members are not cleared to work in the facility: Susanna Gonzalez and Maria Rodriguez..

LIC 9099 dated 11/19/19 has been amended.

Upon receipt the Licensee shall post the Notice of Site Visit. The Notice of Site Visit shall be posted for 30 consecutive days. Failure to maintain posting as required will result in a $100.00 civil penalty.

At this time, the licensee is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued today.

Exit interview was conducted with the Adriana Alvarado, who is in agreement with the above. A copy of this report and all other licensing reports must be made available to the public for 3 years.

SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Reiko JonesTELEPHONE: (323) 558-2739
LICENSING EVALUATOR SIGNATURE:

DATE: 12/13/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2019
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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