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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198022119
Report Date: 05/20/2026
Date Signed: 05/20/2026 09:49:43 AM

Document Has Been Signed on 05/20/2026 09:49 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:EISEN FAMILY CHILD CAREFACILITY NUMBER:
198022119
ADMINISTRATOR/
DIRECTOR:		EISEN, SARAHFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 326-7321
CITY:LOS ANGELESSTATE: CAZIP CODE:
90036
CAPACITY: 14TOTAL ENROLLED CHILDREN: 10CENSUS: 0DATE:
05/20/2026
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:45 AM
MET WITH:Applicant/Licensee: Sarah EisenTIME VISIT/
INSPECTION COMPLETED:
10:15 AM
NARRATIVE
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On 5/20/26, at 8:45AM, Licensing Program Analyst (LPA) Joe Katrdzhyan conducted an announced pre-licensing follow up inspection at the above facility to ensure the corrections requested during the initial pre-licensing inspection conducted on 5/5/2026 had been completed. Upon arrival, LPA met with the Applicant's husband / Moshe Eisen, who guided the LPA on a tour of the facility. The Applicant / Sarah Eisen arrived shortly after and assisted with the visit. During this inspection, the following corrections were observed to have been completed:
  • Install a gate between the side yard and the back yard connection, making the back yard off-limits to children in care.
  • Cover the exposed wires located in the backyard (situated underneath the electrical panel).
  • Trim and maintain trees, shrubs, and plants near the play area in the side yard.
  • Install safety covers for all electrical outlets throughout the home and submit a declaration to Licensing confirming that safety covers have been installed on all electrical outlets.
  • Install soft corner protectors on the dining room table.
  • Place a safety screen on the fireplace.
  • Submit Mandated Reporter Training Certificates for Moshe Eisen and Deena Lichtman.
  • Submit evidence of current immunizations against Measles and Pertussis for Moshe Eisen.
  • Submit a manual for the playground / swing set in the play area showing the age requirements for the children. (Applicant stated that the playground equipment was custom made several years ago, that there is no manual available, and that the individual who built it is no longer around. Instead, the Applicant was asked to submit a Declaration Form / LIC 855 explaining how Applicant will ensure the safety of children while playing outside and using the playground/swing set in order to prevent any potential injuries).
  • Submit receipt of the date of purchase for the fire extinguisher.
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NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Joe Katrdzhyan
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/20/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/20/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: EISEN FAMILY CHILD CARE
FACILITY NUMBER: 198022119
VISIT DATE: 05/20/2026
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The following correction remains outstanding and must be corrected prior to the facility obtaining a Large Family Child Care Home license. The correction must be completed and verified by the due date of 5/26/26.
  • Submit evidence of current immunizations against Influenza and Measles for Deena Lichtman.

A Large Family Child Care Home license will be granted upon receipt and verification of proof that the above correction has been completed. Once licensed, the Applicant shall adhere to the terms, conditions, and limitations stated on the license.

An exit interview was conducted and report was reviewed with Applicant / Sarah Eisen.

A copy of this report was provided to the Applicant. Final license determination will be made upon review by the Licensing Program Manager.


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NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Joe Katrdzhyan
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/20/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2026
LIC809 (FAS) - (06/04)
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