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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197493830
Report Date: 10/30/2023
Date Signed: 10/30/2023 04:25:25 PM

Document Has Been Signed on 10/30/2023 04:25 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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:KONDRASHOV FAMILY CHILD CAREFACILITY NUMBER:
197493830
ADMINISTRATOR:DMITRI KONDRASHOVFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 951-3334
CITY:LOS ANGELESSTATE: CAZIP CODE:
90064
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
10/30/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Maria ValdezTIME COMPLETED:
11:00 AM
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On 10/30/2023 Licensing Program Analyst (LPA)s Judy Laureano and Cristina Castellanos arrived at above mentioned facility to deliver an amended report that was generated on 10/23/2023. Amended report to reflect "public" document.

LPA observed 2 teachers and 9 children.


Copy of report was provided and a Notice of site visit.
SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE: DATE: 10/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/30/2023
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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