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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198018794
Report Date: 05/01/2019
Date Signed: 05/09/2019 12:10:18 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:YMCA OF METROPOLITAN LOS ANGELES LA DOWNTOWN YMCAFACILITY NUMBER:
198018794
ADMINISTRATOR:MONTANO, LISAFACILITY TYPE:
850
ADDRESS:2916 W. 8TH ST.TELEPHONE:
(323) 487-6592
CITY:LOS ANGELESSTATE: CAZIP CODE:
90005
CAPACITY:75CENSUS: 61DATE:
05/01/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Lead TeacherTIME COMPLETED:
09:30 AM
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Licensing Program Analyst (LPA) Tiffanie Tran arrived at the above facility to conduct a case management inspection to observe the level of care and supervision. Upon arrival, LPA proper care and supervision and teacher/children ratio are met. All center staff that was present during today’s visit had fingerprint cleared and associated to the designated license number.

No deficiency was found during today's inspection.

Due to experiencing replication situation, the handwriting 809 report was provided. The original 809 report was generated at the Regional Office and sent on 05/09/19. Facility representative signature will not required.
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Tiffanie TranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 05/09/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2019
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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