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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197493830
Report Date: 09/23/2024
Date Signed: 09/27/2024 10:20:42 AM

Document Has Been Signed on 09/27/2024 10:20 AM - 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: 0DATE:
09/23/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:15 PM
MET WITH:TIME VISIT/
INSPECTION COMPLETED:
01:30 PM
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On 9/23/2024 Licensing Program Analysts (LPA) Judy Laureano at above mentioned facility unannounced, to conduct a Case Management – Other inspection to ensure that care and supervision is not taking place. LPA Laureano arrived at facility at approximatly12:15 p.m.

LPA Laureano walked around the facility and observed children’s outdoor toys in the yard. LPA did not observed any cars in the home driveway. LPA walked up to the home and observed the front porch empty. LPA open the screen door and knocked. LPA observed through the window children’s table and chairs.

LPA did not observed any children or adults in the home. LPA will process the licensee's request to permanently close the home.

LPA left the home at approximately 1:30 p.m.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE: DATE: 09/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/23/2024
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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