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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191602055
Report Date: 07/28/2023
Date Signed: 07/28/2023 09:33:43 AM

Document Has Been Signed on 07/28/2023 09:33 AM - 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:DISCOVERY PRESCHOOL AT LAUCCFACILITY NUMBER:
191602055
ADMINISTRATOR:ROXANNA MENENDEZFACILITY TYPE:
850
ADDRESS:5550 ATHERTON STTELEPHONE:
(562) 596-2108
CITY:LONG BEACHSTATE: CAZIP CODE:
90815
CAPACITY: 38TOTAL ENROLLED CHILDREN: 38CENSUS: 9DATE:
07/28/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Roxanne MenendezTIME COMPLETED:
09:40 AM
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Licensing Program Analyst (LPA) Warren Birks conducted an unannounced case management inspection. LPA met with Director Roxanne Menendez who assisted with the report. The purpose of this inspection is to deliver an amended 7/14/2023 report. The report was amended with verbiage (listed below) indicating the following:

AMENDED TO NOTE THAT THE 7/14/2023 DATE IS A TYPO. THE VISIT TOOK PLACE 7/18/2023.

The Notice of Site Visit (LIC 9213 –must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00 Exit interview was conducted with Director Roxanna Menendez and a copy of Appeal Rights (LIC 9058) was discussed and provided

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Warren Birks
LICENSING EVALUATOR SIGNATURE: DATE: 07/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/28/2023
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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