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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400006
Report Date: 11/26/2024
Date Signed: 11/26/2024 01:17:38 PM

Document Has Been Signed on 11/26/2024 01:17 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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:GREEN FAMILY CHILD CAREFACILITY NUMBER:
198400006
ADMINISTRATOR/
DIRECTOR:
JENAE GREENFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 713-1163
CITY:LONG BEACHSTATE: CAZIP CODE:
90805
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 10DATE:
11/26/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:25 PM
MET WITH:Licensee, Jenae GreenTIME VISIT/
INSPECTION COMPLETED:
01:30 PM
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On November 26, 2024, at 12:25p.m., Licensing Program Analyst (LPA) Keneisha Dunlap arrived at the above facility for the purpose of an unannounced Case Management visit. LPA Dunlap announced the purpose of the visit and was granted entry into the facility by Licensee, Jenae Green. This is a unannounced visit based upon Licensee filing UIR with department on June 21, 2024. The Licensee notified LPA Dunlap on November 26, 2024, via phone that the AUD construction had been completed on property. There are 14 children enrolled, and 10 children present at the time of visit. All adults in the home were discussed and have current criminal background clearance.

At 12:30p.m., LPA Dunlap observed the backyard area where the AUD is located. The front door of AUD faces the play area for children. The side of the AUD has 2 gates where trash cans are located, and another back gate that leads to back of the AUD.

The outside play area has artificial grass, bikes, shaded area, sand box, and age appropriate toys. LPA Dunlap observed outside play area to be in good condition, free of sharp, loose or pointed parts.

The children will no longer will be using the fenced in driveway for the outdoor play area.

At 12:50p.m., LPA Dunlap discussed with the Licensee that since the AUD is a separate address that the future resident will not have to obtain criminal background clearance. However, the Licensee will have to have a plan of supervision on how to keep the potential resident and/or potential residence guest(s) separate from when children are present during hours of operation of the facility.

The Licensee agreed to submit their plan of supervision by December 6, 2024.

A Notice of Site Visit was given and must remain posted for 30 days.

Appeal rights given.

Exit interview conducted and reviewed with Licensee- Jenae Green. Page 1 of 1

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Keneisha Dunlap
LICENSING EVALUATOR SIGNATURE: DATE: 11/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/26/2024
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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