Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198016467
Report Date: 07/27/2017
Date Signed: 07/27/2017 08:50:11 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: 10DATE:
07/27/2017
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
08:25 AM
MET WITH:Marlin Medrano, LicenseeTIME COMPLETED:
08:50 AM
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LPA Lucero conducted an unannounced Plan of Correction inspection to determine if the citation cited on 10/18/2016 has been corrected.

The following citation cited on 10/18/2016 has been corrected:

1. Staffing Ratio
2. Capacity
3. Current Roster of children in care.

On the date of this Plan of Correction inspection, LPA observed that the citation mentioned above has been corrected.

Upon receipt of this report, the Licensee shall post the Notice of Site Visit and any Licensing report documenting a type “A” deficiency. The report and the Notice of Site Visit shall be posted for 30 consecutive days.

Exit interview, copy of report was given. Appeal rights were issued and discussed.
SUPERVISOR'S NAME: Cassandra CooperTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Armando J LuceroTELEPHONE: (323) 981-3435
LICENSING EVALUATOR SIGNATURE:

DATE: 07/27/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2017
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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