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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393611424
Report Date: 10/14/2024
Date Signed: 10/14/2024 01:11:04 PM

Document Has Been Signed on 10/14/2024 01:11 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
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:ANGELES, FEBE EFACILITY NUMBER:
393611424
ADMINISTRATOR/
DIRECTOR:		ANGELES, FEBE EFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 982-5448
CITY:LATHROPSTATE: CAZIP CODE:
95330
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 6DATE:
10/14/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:00 PM
MET WITH:Febe E AngelesTIME VISIT/
INSPECTION COMPLETED:
02:00 PM
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Licensing Program Analyst (LPA) Erwin Tjhia met with licensee, Febe E Angeles follow up on the Unusual Incident Report (UIR) submitted to Community Care Licensing on 10/09/2024. LPA arrived at the facility and disclosed the purpose of the inspection. Criminal background clearances were verified.

LPA conducted staff interviews, reviewed records, and observed care and supervision of children. LPA requested a copy of the Facility Roster, and supporting documentation pertinent to the investigation.


Facility Evaluation report was reviewed and discussed with licensee, Febe E Angeles. Exit interview was conducted. A Notice of Site Visit was posted by the LPA and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

In the areas that were evaluated, no deficiencies were cited during today's inspection.
SUPERVISORS NAME: Karyn Guerra
LICENSING EVALUATOR NAME: Erwin Tjhia
LICENSING EVALUATOR SIGNATURE: DATE: 10/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/14/2024
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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