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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400520
Report Date: 04/14/2022
Date Signed: 04/14/2022 02:08:11 PM

Document Has Been Signed on 04/14/2022 02:08 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:DAVID FAMILY CHILD CAREFACILITY NUMBER:
198400520
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
04/14/2022
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
10:25 AM
MET WITH:Michelle David, ApplicantTIME COMPLETED:
11:10 AM
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An office meeting was conducted on this date 04/14/2022 with applicant Michelle David. Also in attendance was Regional Manager (RM) Sharon Greene, Licensing Program Manager (LPM) Valarie Cook and Licensing Program Analyst (LPA) Susann Sanchez. This office visit is being conducted via Microsoft Teams. The purpose of the office meeting is to discuss applicants history, future plans and resources.

The following was discussed:
  • History
  • Discipline Plan - redirection
  • Monitoring Dog Daycare and Child Daycare- doggy daycare will only be on the weekends
  • Infants- safe sleep
  • Unusual Incident Reporting

Licensee was advised of the following:
  1. Attend local licensing calls
  2. Join the TSP program
  3. Sign up for quarterly updates and PINS
  4. Conduct daily health checks
Exit interview was conducted with Applicant Michelle David.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Susann Sanchez
LICENSING EVALUATOR SIGNATURE: DATE: 04/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/14/2022
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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