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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406216190
Report Date: 08/02/2024
Date Signed: 08/02/2024 01:45:28 PM

Document Has Been Signed on 08/02/2024 01:45 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
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:TESFAZGY FCC AKA LITTLE WORLD CHILD CAREFACILITY NUMBER:
406216190
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
08/02/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:20 PM
MET WITH:Milen TesfazgyTIME VISIT/
INSPECTION COMPLETED:
01:55 PM
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On 08/02/2024, Licensing Program Analysts (LPAs) Martina Jimenez and Joaquin Mendez, conducted an unannounced Annual Required Inspection. LPAs met with Milen Tesfazgy, Licensee. The purpose of the inspection was discussed and LPAs with the Licensee together we toured the inside and outside of the home. LPAs observed no children in care at the time of the inspection.

Licensee, stated the FCCH is closed from 07/29/2024 thru 08/02/2024 at 9:00PM. This inspection will resume on a late date when the FCCH is operating and children are present.

A notice of site visit was given to licensee, and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Exit interview conducted and report was reviewed with the .Milen Tesfazgy, Licensee.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Martina Jimenez
LICENSING EVALUATOR SIGNATURE: DATE: 08/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/02/2024
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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