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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198018993
Report Date: 07/13/2022
Date Signed: 07/13/2022 09:37:41 PM

Document Has Been Signed on 07/13/2022 09:37 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:MASSEY FAMILY CHILD CAREFACILITY NUMBER:
198018993
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
07/13/2022
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Ameerah Massey, LicenseeTIME COMPLETED:
01:40 PM
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ATTEMPTED VISIT - LPA went to the licensee's address above. There was street cleaning, had to park around the block. LPA knocked on door and no answer. LPA did not observe or hear any noise inside.
LPA called the licensee's phone number two times and no answer. LPA went back to car and received a call from the licensee. Licensee was at the dentist. LPA advised the licensee that when she is closed to email or call the LPA to notify and document in the system when needed.

Licensee emailed LPA as advised at 5:57pm 07/13/22 to notify of closure of daycare for the day due to medical appointment.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Dayna Chambers
LICENSING EVALUATOR SIGNATURE: DATE: 07/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/13/2022
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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