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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198014584
Report Date: 01/18/2024
Date Signed: 01/18/2024 09:57:42 AM

Document Has Been Signed on 01/18/2024 09:57 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:CELIS FAMILY CHILD CAREFACILITY NUMBER:
198014584
ADMINISTRATOR:CELIS, KELLYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 429-9646
CITY:LAKEWOODSTATE: CAZIP CODE:
90712
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
01/18/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Kelly CelisTIME COMPLETED:
10:10 AM
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Licensing Program Analyst (LPA), Warren Birks conducted an unannounced case management inspection for the purpose of observing infant ratio and a signed memo for parents indicating parent rights regarding entering the facility. Upon arrival, LPA met Licensee and observed the Licensee and two cleared assistants caring for nine children (4 infants and 5 preschool).

The following items have been cleared:
1. Capacity and Ratio for Large Family Child Care: Twelve children, no more than four of whom may be infants. Cleared by observance of disenrollment.

2. Parent's Rights: To enter and inspect the family child care home in accordance with Health and Safety Code Section 1596.857. Cleared with memo to parents

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: Warren Birks
LICENSING EVALUATOR SIGNATURE: DATE: 01/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/18/2024
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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