Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 192002652
Report Date: 08/25/2017
Date Signed 08/25/2017 03:16:42 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:TORRES FAMILY CHILD CAREFACILITY NUMBER:
192002652
ADMINISTRATOR:ROSA TORRESFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 404-5219
CITY:NORWALKSTATE: CAZIP CODE:
90650
CAPACITY:14CENSUS: 8DATE:
08/25/2017
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Rosa TorresTIME COMPLETED:
03:31 PM
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Licensing Program Analyst (LPA) Raul Navarro conducted an unannounced Case Management inspection in Spanish for the purpose of correcting a report made incorrectly to this facility dated 6/22/17. LPA met with Licensee Rosa Torres who guided LPA on a tour of the facility both inside and outdoor. During the time of the inspection there were 8 children present.

LPA Navarro explained to Licensee why inspection was made. Licensee signed and received of copy of the amended report as well as a copy of this report.

Exit interview was conducted with Licensee. The Licensee was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these forms.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site inspection by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.
SUPERVISOR'S NAME: Katherine HarewoodTELEPHONE: (323) 981-2956
LICENSING EVALUATOR NAME: Raul NavarroTELEPHONE: 323-981-3388
LICENSING EVALUATOR SIGNATURE:

DATE: 08/25/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2017
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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