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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019842
Report Date: 10/03/2019
Date Signed: 10/03/2019 01:47:46 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:TORRES FAMILY CHID CAREFACILITY NUMBER:
198019842
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 5DATE:
10/03/2019
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Ericka Maria Torres, LicenseeTIME COMPLETED:
01:55 PM
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LPA Lucero conducted an unannounced Plan of Correction (POC) Inspection to determine if the citations cited on 09/27/2019 have been corrected.

The following citations cited on 09/27/2019 have been corrected:

1. Staffing Ratio and Capacity - On this date, LPA observed five children in care. Licensee stated that she understands that her capacity is for eight children.
2. Operation of a Family Child Care Home - Facility has an updated Roster.
3. Admission Procedures and Parental and Authorized Representative's Rights - LIC 995A is in child files.

On the date of this Plan of Correction inspection, LPA observed that both citations mentioned above have been corrected.

Upon receipt of this report, the Licensee shall post the Notice of Site Visit and any Licensing report documenting a type “A” deficiency. The report and the Notice of Site Visit shall be posted for 30 consecutive days.

Exit interview, copy of report was given. Appeal rights were issued and discussed.
SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Armando J LuceroTELEPHONE: (323) 981-3435
LICENSING EVALUATOR SIGNATURE:

DATE: 10/03/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2019
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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