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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198008186
Report Date: 10/11/2024
Date Signed: 10/11/2024 09:59:37 AM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 10/11/2024 09:59 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:WILLIS FAMILY CHILD CAREFACILITY NUMBER:
198008186
ADMINISTRATOR/
DIRECTOR:		WILLIS, LOLITAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 208-5054
CITY:LONG BEACHSTATE: CAZIP CODE:
90804
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 8DATE:
10/11/2024
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Lolita WIllis, LicenseeTIME VISIT/
INSPECTION COMPLETED:
10:20 AM
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Licensing Program Analyst (LPA) Dayna Chambers conducted an unannounced annual inspection to the above facility on October 11, 2024. LPA arrived at the facility at 9:00am,identified self and met with Licensee Lolita Willis. Also present were three assistants. Due to the electricity going out during the initial inspection. All children will be sent home now. LPA will continue inspection on a later date.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Dayna Chambers
LICENSING EVALUATOR SIGNATURE: DATE: 10/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/11/2024
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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