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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197493072
Report Date: 07/10/2024
Date Signed: 07/11/2024 08:13:41 AM

Document Has Been Signed on 07/11/2024 08:13 AM - 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 RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:PACLEB FAMILY CHILD CAREFACILITY NUMBER:
197493072
ADMINISTRATOR/
DIRECTOR:		PACLEB, BYANKAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(424) 500-2960
CITY:CULVER CITYSTATE: CAZIP CODE:
90230
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 4DATE:
07/10/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Byanka PaclebTIME VISIT/
INSPECTION COMPLETED:
11:35 AM
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On 7/10/24 Licensing Program Analyst (LPA) Ranita Richmond arrived at the above mentioned home at 8:00am to conduct an unannounced case management visit. LPA was greeted by licensee Byanka Pacleb. LPA met with the licensee to discuss the reason for the visit. LPA toured the facility and observed 13 children being cared for and supervised by 4 staff members.


LPA conducted visit to capture signature on amended 9099 created on 4/17/24. Amendment was completed to update the allegation.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no citations were cited today.

Exit interview conducted, and report was reviewed with licensee Byanka Pacleb.

A Notice of Site Visit was provided and must remain posted for 30 days.
SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Ranita Richmond
LICENSING EVALUATOR SIGNATURE: DATE: 07/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/10/2024
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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