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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198014901
Report Date: 10/13/2023
Date Signed: 10/13/2023 12:40:21 PM

Document Has Been Signed on 10/13/2023 12:40 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:GRACIAN FAMILY CHILD CAREFACILITY NUMBER:
198014901
ADMINISTRATOR:GRACIAN, PATRICIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 865-6546
CITY:HAWAIIAN GARDENSSTATE: CAZIP CODE:
90716
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
10/13/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Patricia GracianTIME COMPLETED:
01:05 PM
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Licensing Program Analyst (LPA) Raul Navarro conducted an unannounced Case Management inspection. LPA met with Licensee Patricia Gracian who guided this LPA on a tour of the facility. There were nine children with two adults present during today’s inspection.

The purpose of today's inspection was to make sure Adult #1 and Adult #2 are not present or assisting at the day care. Per Licensee, Adult #1 and Adult #2 do not assist in caring for children in her day care or come inside the facility when day care children are present. LPA reviewed Licensee's associations and the names of Adult #1 and Adult #2 are not on the list. LPA Navarro did not observe Adult #1 and Adult #2 in the facility during today's inspection.

Exit interview was conducted with Licensee Patricia Gracian.

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.
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Raul Navarro
LICENSING EVALUATOR SIGNATURE: DATE: 10/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/13/2023
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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