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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198011159
Report Date: 09/17/2024
Date Signed: 09/17/2024 09:38:38 AM

Document Has Been Signed on 09/17/2024 09:38 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:NHEK FAMILY CHILD CARE HOMEFACILITY NUMBER:
198011159
ADMINISTRATOR/
DIRECTOR:		NHEK, BORYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 989-1710
CITY:LONG BEACHSTATE: CAZIP CODE:
90806
CAPACITY: 12TOTAL ENROLLED CHILDREN: 12CENSUS: 0DATE:
09/17/2024
TYPE OF VISIT:CollateralUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Licensee, Bory NhekTIME VISIT/
INSPECTION COMPLETED:
10:00 AM
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On 09/17/24, Licensing Program Analyst (LPA) Dayna Chambers conducted an unannounced case management inspection for the purpose of delivering the amended Complaint Investigation Report LIC 9099 dated 08/27/24.

LPA met with licensee Bory Nhek and explained the reason for the visit. Licensee provided a tour of the facility. LPA confirmed that there were no children in care. Licensee, daughter, and spouse were observed to be the only adults present in the home during the visit.

LPA Chambers reviewed amended report with Licensee. Licensee signed the amended report and provided a copy of the amended report to the Licensee.

The Notice of Site Visit (LIC 9213 ) was provided to the Licensee. The Notice of Site Visit 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 Licensee Bory Nhek and a copy of this report was provided.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Dayna Chambers
LICENSING EVALUATOR SIGNATURE: DATE: 09/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/17/2024
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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