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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191204631
Report Date: 04/23/2024
Date Signed: 04/23/2024 12:27:10 PM

Document Has Been Signed on 04/23/2024 12:27 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:SUSANNA WESLEY CHILDREN'S CENTERFACILITY NUMBER:
191204631
ADMINISTRATOR/
DIRECTOR:		MORENA DURANFACILITY TYPE:
850
ADDRESS:134 N. KENWOOD ST.TELEPHONE:
(818) 548-6229
CITY:GLENDALESTATE: CAZIP CODE:
91206
CAPACITY: 36TOTAL ENROLLED CHILDREN: 36CENSUS: 9DATE:
04/23/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:00 PM
MET WITH:Stephanie Rice, PastorTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
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Licensing Program Analyst (LPA), Anomeh Eivazian conducted an unannounced Plan of Correction (POC) inspection to the above facility on 04/23/24 to ensure Type B deficiency cited on 04/03/24 has been cleared. LPA arrived at 12:00 PM and met with Stephanie Rice, Pastor of Church who guided analyst on a tour of the facility. During this inspection there were 9 children present in the facility with one staff.

The following has been observed:
During this inspection Pastor Rice provided LPA a copy of Intern Director, Maricela Hernandez qualifications. Per Pastor Rice currently Maricela Hernandez will act as Intern director until they be able to hire a director.

LPA cleared deficiency on this date and provided a copy of the Licensing Report to Pastor Rice and issued POC clearance letter.

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

The Notice of Site Visit (LIC 9213) was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the Pastor Rice at 12:30 p.m..


SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE: DATE: 04/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/23/2024
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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