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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 192006738
Report Date: 08/22/2023
Date Signed: 08/22/2023 12:25:51 PM

Document Has Been Signed on 08/22/2023 12:25 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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:LAVELLE FAMILY CHILD CAREFACILITY NUMBER:
192006738
ADMINISTRATOR:LAVELLE, L & KELLY, S.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 930-5769
CITY:COMPTONSTATE: CAZIP CODE:
90222
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 1DATE:
08/22/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Lorna Lavelle, LicenseeTIME COMPLETED:
12:15 PM
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On August 22, 2023 at 10:00am, Licensing Program Analyst (LPA) Dayna Chambers arrived at the above facility to conduct a Case Management Incident inspection to clear deficiencies that occurred on May 04, 2023. LPA provided resources on immunizations, safe sleep, operation of a family child care home, LIC311D, trained which documents need to be in files, and the Title 22 regulations.
An exit interview was conducted with Licensee Lorna Lavelle; the notice of site visit must be posted for 30 days upon receipt.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Dayna Chambers
LICENSING EVALUATOR SIGNATURE: DATE: 08/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/22/2023
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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