Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198016467
Report Date: 04/19/2017
Date Signed: 04/19/2017 09:41:36 AM

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:MEDRANO & AGUIRRE FAMILY CHILD CAREFACILITY NUMBER:
198016467
ADMINISTRATOR:MEDRANO, M & AGUIRRE, WFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 699-2549
CITY:WHITTIERSTATE: CAZIP CODE:
90606
CAPACITY:14CENSUS: 8DATE:
04/19/2017
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:20 AM
MET WITH:Marlen Aguirre & Jessica HuertaTIME COMPLETED:
09:50 AM
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Case Management inspection conducted by LPAs Jennifer Hua & Raul Navarro. The purpose of this visit is obtain additional information regarding the complaint that was received on 1/10/17. LPAs met with licensee and observed 8 children present supervised by Licensee and her assistant Jessica Huerta. Licensee's mother-in-law is not present during this visit. Children were interviewed during this visit.

LPA Navarro serve as translator since licensee is Spanish speaking.

No deficiency cited during this visit.

An exit interview conducted, copy of report given. Notice of Site Visit Form was provided and explained.
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Jennifer HuaTELEPHONE: (323) 981-3375
LICENSING EVALUATOR SIGNATURE:

DATE: 04/19/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2017
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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