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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020404
Report Date: 01/09/2024
Date Signed: 01/09/2024 02:42:22 PM


Document Has Been Signed on 01/09/2024 02:42 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754



FACILITY NAME:DISNEY CHILDREN'S CENTERFACILITY NUMBER:
198020404
ADMINISTRATOR:ELISHA GONZALEZFACILITY TYPE:
830
ADDRESS:625 PAULA STTELEPHONE:
(818) 931-5437
CITY:GLENDALESTATE: CAZIP CODE:
91201
CAPACITY:54CENSUS: 31DATE:
01/09/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Elisha Gonzalez, DirectorTIME COMPLETED:
03:00 PM
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Licensing Program Analyst (LPA) Anomeh Eivazian conducted an unannounced case management inspection on 01/09/24 at 1:30 PM due to an anonymous email that was received on 12/08/23. LPA met with Elisha Gonzales, Director who guided analyst on a tour of the facility.

LPA obtained December 2023 Illness Notifications and staff workplace illness Policy.

At this time, there is not a preponderance of evidence that shows that the facility was in violation with Title 22 Regulations based on 12/08/23 anonymous email was was received. Therefore, there are no deficiencies being cited.

The Notice of Site Visit (LIC 9213) was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.


Exit interview conducted and report was reviewed with the director, Elisha Gonzalez at 3:00 PM.
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Anomeh EivazianTELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:
DATE: 01/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/09/2024
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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