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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020091
Report Date: 12/08/2021
Date Signed: 12/08/2021 03:16:56 PM

Document Has Been Signed on 12/08/2021 03:16 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:LOPEZ FAMILY CHILD CAREFACILITY NUMBER:
198020091
ADMINISTRATOR:CANDELARIA LOPEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 257-8703
CITY:NORWALKSTATE: CAZIP CODE:
90650
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 10DATE:
12/08/2021
TYPE OF VISIT:CollateralUNANNOUNCEDTIME BEGAN:
02:20 PM
MET WITH:Candelaria Lopez, LicenseeTIME COMPLETED:
03:40 PM
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Licensing Program Analyst (LPA) A. Lucero conducted an unannounced collateral inspection for the purpose of obtaining information and interviewing child 1, 2, and 3. LPA is investigating an incident that occurred at another licensed child care facility that the children attended. Children currently attend Lopez FCCH and were present to be interviewed at this location.

No deficiencies were cited on this inspection.

Exit interview conducted with Licensee Candelaria Lopez. A copy of this report was provided.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Armando J Lucero
LICENSING EVALUATOR SIGNATURE: DATE: 12/08/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/08/2021
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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