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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
198205366
Report Date:
09/26/2022
Date Signed:
09/26/2022 05:05:55 PM
Document Has Been Signed on
09/26/2022 05:05 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
EL SEGUNDO
,
1000 CORPORATE DR #100
MONTEREY PARK
,
CA
91754
FACILITY NAME:
BRIANA'S VILLA, INC.
FACILITY NUMBER:
198205366
ADMINISTRATOR:
CYNTHIA REED/FLORD LEE
FACILITY TYPE:
740
ADDRESS:
6106 S. LA BREA AVENUE
TELEPHONE:
(323) 299-9604
CITY:
LOS ANGELES
STATE:
CA
ZIP CODE:
90056
CAPACITY:
6
CENSUS:
4
DATE:
09/26/2022
TYPE OF VISIT:
Required - 1 Year
UNANNOUNCED
TIME BEGAN:
11:05 AM
MET WITH:
TIME COMPLETED:
11:15 AM
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Licensing Program Analyst (LPA) Martessa Brown made an unannounced annual visit to the above facility and there was no administrator or staff present at the time of visit. See 812 for additional information.
SUPERVISOR'S NAME:
Ulysses Coronel
TELEPHONE:
(323) 981-1755
LICENSING EVALUATOR NAME:
Martessa Brown
TELEPHONE:
(714) 743-4597
LICENSING EVALUATOR SIGNATURE:
DATE:
09/26/2022
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
09/26/2022
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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