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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198601378
Report Date: 02/12/2024
Date Signed: 02/12/2024 12:49:48 PM

Document Has Been Signed on 02/12/2024 12:49 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
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME:CHOIX VOCATIONAL SERVICESFACILITY NUMBER:
198601378
ADMINISTRATOR:MARIA ZAMBRANOFACILITY TYPE:
775
ADDRESS:204 S.ATLANTIC BLVD STE #1,2,4TELEPHONE:
(323) 727-5033
CITY:LOS ANGELESSTATE: CAZIP CODE:
90022
CAPACITY: 60CENSUS: 55DATE:
02/12/2024
TYPE OF VISIT:CollateralUNANNOUNCEDTIME BEGAN:
12:27 PM
MET WITH:Ariana Alvillar, Program SupervisorTIME COMPLETED:
01:00 PM
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Licensing Program Analyst (LPA) Cynthia Chan conducted a collateral visit to interview 2 Clients. LPA met with Program Supervisor, Ariana Alvillar, and explained the reason for the visit.

LPA interviewed both clients regarding concerns at their licensed home where they reside.

A copy of this report was provided to the Program Supervisor.
SUPERVISORS NAME: Tony Vasallo
LICENSING EVALUATOR NAME: Cynthia D Chan
LICENSING EVALUATOR SIGNATURE: DATE: 02/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/12/2024
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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