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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198203257
Report Date: 08/04/2022
Date Signed: 08/04/2022 02:07:17 PM

Document Has Been Signed on 08/04/2022 02:07 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 DR #100
MONTEREY PARK, CA 91754
FACILITY NAME:CHALLENGE 2FACILITY NUMBER:
198203257
ADMINISTRATOR:GILBERT TEELFACILITY TYPE:
735
ADDRESS:2504 W. 164TH STREETTELEPHONE:
(310) 324-6465
CITY:TORRANCESTATE: CAZIP CODE:
90504
CAPACITY: 4CENSUS: 4DATE:
08/04/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:35 PM
MET WITH:Juanita Ricker House MgrTIME COMPLETED:
02:34 PM
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On 6/28/22 during annual inspection Administrator Lawrence Phillips was not able to provide access to back-end of the garage however he stated that he would obtain key from owner to provide LPA access to area within 10 days. On today house manager Juanita Ricker opened rear storage area behind the garage and LPA was able to view the locked storage area which contained various items bicycles, Christmas decorations and other general items none were hazardous.
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Jeremiah Randle
LICENSING EVALUATOR SIGNATURE: DATE: 08/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/04/2022
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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