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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198007286
Report Date: 04/13/2023
Date Signed: 04/13/2023 03:19:47 PM

Document Has Been Signed on 04/13/2023 03:19 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:CHILD LANEFACILITY NUMBER:
198007286
ADMINISTRATOR:DIANE PAYTONFACILITY TYPE:
850
ADDRESS:2205 SAN GABRIEL AVE.TELEPHONE:
(562) 388-8160
CITY:LONG BEACHSTATE: CAZIP CODE:
90810
CAPACITY: 71TOTAL ENROLLED CHILDREN: 71CENSUS: 55DATE:
04/13/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:55 PM
MET WITH:Latayna WhiteTIME COMPLETED:
03:35 PM
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Licensing Program Analyst Raul Navarro conducted an unannounced inspection on 4/13/2023 at 02:55pm. LPA met with Latayna White, Site Supervisor. There were 55 children present when LPA Navarro arrived. The purpose of today's inspection was to correct the annual inspection report conducted on 03/28/23. The report was amended to make the appropriate corrections.

LPA conducted an exit interview with Site Supervisor Latayna White. There are no citations being issued today.

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.

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Raul Navarro
LICENSING EVALUATOR SIGNATURE: DATE: 04/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/13/2023
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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