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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198401127
Report Date: 09/10/2024
Date Signed: 09/10/2024 03:27:08 PM

Document Has Been Signed on 09/10/2024 03:27 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:GROW AND LEARN CENTERFACILITY NUMBER:
198401127
ADMINISTRATOR/
DIRECTOR:		HANNAH, BETTYFACILITY TYPE:
860
ADDRESS:12183 FIRESTONE BLVDTELEPHONE:
(562) 556-1338
CITY:NORWALKSTATE: CAZIP CODE:
90650
CAPACITY: 30TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
09/10/2024
TYPE OF VISIT:OfficeUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:00 PM
MET WITH:Betty HannahTIME VISIT/
INSPECTION COMPLETED:
03:45 PM
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An office meeting was conducted with Applicant, Betty Hannah. The purpose of this meeting is to discuss and review the pending application that was received on 07/18/2024.

The following was discussed with the Applicant and items that need to be updated:
· Application for Child Care Center License (LIC 200A)
· Administrative Organization (LIC 309)
· Articles of Organization (Secretary of State and Operating Agreement)
· Personnel Report (LIC 500)
· Monthly Operating Statement (LIC 401)
· Facility Sketch
· Job descriptions
· Personnel Policies
· In-Service Training Plan
· Parent and Employee handbook.
· Admissions Agreement
· Statement Acknowledging Requirement to Report Suspected Child Abuse (LIC 9108)
· Sample Menu
· List of Furniture & Play Equipment
· Control of Property

Applicant states that she will provide all missing documents & updated documents by 09/27/2024.

Exit interview conducted with Betty Hannah, Applicant who is in agreement with this report which documents this meeting.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Elka Chavez
LICENSING EVALUATOR SIGNATURE: DATE: 09/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/10/2024
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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