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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197493830
Report Date: 04/04/2024
Date Signed: 04/16/2024 03:04:44 PM

Document Has Been Signed on 04/16/2024 03:04 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/
DIRECTOR:		DMITRI KONDRASHOVFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 951-3334
CITY:LOS ANGELESSTATE: CAZIP CODE:
90064
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 8DATE:
04/04/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:00 AM
MET WITH:Maria Valdez- TeacherTIME VISIT/
INSPECTION COMPLETED:
10:00 AM
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On 04/04/2024 Licensing Program Analyst (LPA), Judy Laureano conducted an unannounced case management inspection at the above mentioned home to ensure that home is meeting regulations.

LPA arrived at home at approximately 8:25 a.m. met with teacher Maria Valdez. At approximately 8:37 a.m. Teacher Zhang arrived at home.

During the initial inspections, LPA observed 4 children in care.

At the end of the inspection LPA observed 8 children in total.

LPA Laureano initiated interviews and took pictures of the home.

Exit interview was conducted and report was reviewed with Teacher Maria Valdez.

A Notice of Site Visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE: DATE: 04/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/04/2024
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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