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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019793
Report Date: 06/18/2020
Date Signed: 06/18/2020 02:51:43 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:HADLEY PRE-SCHOOLFACILITY NUMBER:
198019793
ADMINISTRATOR:DIANE YORK LAWRENCEFACILITY TYPE:
850
ADDRESS:11703 E HADLEY AVETELEPHONE:
(562) 699-0539
CITY:WHITTERSTATE: CAZIP CODE:
90601
CAPACITY:105CENSUS: 32DATE:
06/18/2020
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
02:24 PM
MET WITH:Diane YorkTIME COMPLETED:
03:00 PM
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A follow up prelicensing inspection conducted by Licensing Program Analyst, Jose Guzman. LPA met with applicant, Diane York. The purpose of the follow up inspection is to ensure all corrections noted on licensing report dated 06/10/2020 are complete.

LPA observed mesh was attached to the climbable chain linked fence door located in the back portion of the pool area
LPA received a current staff on LIC 500
LPA received Pediatric First Aid/CPR EMSA approved
LPA received an approved Health and Safety course certificate
LPA received immunization records for Diane York
LPA received and update parent handbook (water activities ratios)
Based on observations today, facility is ready to be licensed.

The LIC 9213, Notification of a Site Visit must be posted. This notice is to be posted for 30 consecutive days. Failure to keep this notice posted for the 30 consecutive days will result in an immediate $100 civil penalty.

Exit interview conducted with Applicant, and a copy of report was given. Appeal rights were issued and discussed.
SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Jose GuzmanTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 06/18/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2020
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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