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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
198018214
Report Date:
06/07/2022
Date Signed:
06/07/2022 02:03:12 PM
Document Has Been Signed on
06/07/2022 02:03 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:
LAGOON PLAYGROUP
FACILITY NUMBER:
198018214
ADMINISTRATOR:
RACHEL MCBRIDE
FACILITY TYPE:
850
ADDRESS:
5119 COLORADO STREET
TELEPHONE:
(562) 498-1663
CITY:
LONG BEACH
STATE:
CA
ZIP CODE:
90814
CAPACITY:
15
TOTAL ENROLLED CHILDREN:
15
CENSUS:
0
DATE:
06/07/2022
TYPE OF VISIT:
Required - 1 Year
UNANNOUNCED
TIME BEGAN:
01:15 PM
MET WITH:
Director, Heather Sanchez
TIME COMPLETED:
01:45 PM
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SUPERVISORS NAME
:
Valarie Cook
LICENSING EVALUATOR NAME
:
Dayna Chambers
LICENSING EVALUATOR SIGNATURE
:
DATE:
06/07/2022
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
06/07/2022
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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