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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197411657
Report Date: 01/05/2024
Date Signed: 01/05/2024 01:24:52 PM

Document Has Been Signed on 01/05/2024 01:24 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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:CHILDREN'S COLLECTIVE - YOU CHILD DEVELOPMENTFACILITY NUMBER:
197411657
ADMINISTRATOR:JEANETTE BANUELOSFACILITY TYPE:
850
ADDRESS:932 W. 85TH STREETTELEPHONE:
(323) 789-1873
CITY:LOS ANGELESSTATE: CAZIP CODE:
90044
CAPACITY: 10TOTAL ENROLLED CHILDREN: 10CENSUS: 5DATE:
01/05/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:40 AM
MET WITH:Donna BelvinTIME COMPLETED:
12:15 PM
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On 1/5/2024 Licensing Program Analysts (LPA), Judy Laureano and Ranita Richmond conducted an unannounced case management inspection to capture signatures on LIC 809 and LIC 809 D report that was originally created and provided to facility on 1/4/2024. LPAs met with by Donna Belvin.

LPAs observed 5 children eating lunch and 2 staff members in classroom.

Exit interview conducted and report was reviewed with the licensee Donna Belvin.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE: DATE: 01/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/05/2024
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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