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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197412405
Report Date: 11/06/2024
Date Signed: 11/06/2024 03:48:06 PM

Document Has Been Signed on 11/06/2024 03:48 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:MADRIAGA FAMILY CHILD CAREFACILITY NUMBER:
197412405
ADMINISTRATOR/
DIRECTOR:
MADRIAGA, DORISFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 348-2976
CITY:CANOGA PARKSTATE: CAZIP CODE:
91304
CAPACITY: 14TOTAL ENROLLED CHILDREN: 11CENSUS: 3DATE:
11/06/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:30 PM
MET WITH:Doris MadriagaTIME VISIT/
INSPECTION COMPLETED:
04:00 PM
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Licensing Program Analysts (LPAs) Tatiana Bickham conducted an unannounced annual required inspection at the above facility on 11/06/2024 at 2:25 PM.  LPA met with Doris Madriaga, Licensee who guided analyst on a tour of the facility. LPA provided Licensee with a copy of the LIC 126 Entrance Checklist to help facilitate the inspection. Facility is open 24 hours, 7 days a week.

All areas identified on the Facility Sketch were inspected.

There were 3 children present when LPAs arrived. The facility was observed to be within the license capacity and limitations.

Licensee was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Due to time constraints the Annual visit will be completed on a future date.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with Doris Madriaga, Licensee.
SUPERVISORS NAME: Raul Navarro
LICENSING EVALUATOR NAME: Tatiana Bickham
LICENSING EVALUATOR SIGNATURE: DATE: 11/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/06/2024
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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