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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198018144
Report Date: 05/17/2022
Date Signed: 05/17/2022 03:47:03 PM

Document Has Been Signed on 05/17/2022 03:47 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:MAGHOUL FAMILY CHILD CAREFACILITY NUMBER:
198018144
ADMINISTRATOR:MAGHOUL, SHOHREHFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 965-7992
CITY:LONG BEACHSTATE: CAZIP CODE:
90808
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 8DATE:
05/17/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:35 PM
MET WITH:Shohreh MaghoulTIME COMPLETED:
04:00 PM
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Licensing Program Analyst (LPA) Warren Birks conducted an unannounced Case Management Inspection. LPA met with Licensee Shohreh Maghoul who guided LPA on a tour of the facility. The purpose of today's inspection is to verify that items from a previous inspection was cleared. The Licensee and cleared assistants were caring for eight children.

The following items are cleared:

1. Vehicle was removed from backyard driveway.
2. License installed an iron gate in the backyard preventing access to various chemicals and cleaners.
3. Licensee removed blankets from crib.
4. Licensee and staff have completed Mandated Reporter Training.
5. Licensee renewed CPR.
6. Child #1 and #10 have a complete Emergency Form.
7. Infant Sleep plans were provided to infants.

All items are cleared and there are no citations.

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. This report along with a copy of the appeal rights was provided. Exit interview was conducted with Licensee Shoreh Maghoul.
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Warren Birks
LICENSING EVALUATOR SIGNATURE: DATE: 05/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/17/2022
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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