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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019971
Report Date: 03/23/2022
Date Signed: 03/23/2022 12:41:23 PM

Document Has Been Signed on 03/23/2022 12:41 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:DELMAR FAMILY CHILD CAREFACILITY NUMBER:
198019971
ADMINISTRATOR:JESSICA DELMARFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 999-2071
CITY:LONG BEACHSTATE: CAZIP CODE:
90808
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 12DATE:
03/23/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Jessica DelmarTIME COMPLETED:
12:50 PM
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Licensing Program Analyst (LPA) Warren Birks conducted an unannounced Case Management inspection. Upon arrival LPA observed Licensee Jessica Delmar and cleared assistant caring for 12 children during the facility early bird session.

The purpose of today's inspection is to provide the Licensee with a previous report in which a line was added to indicate typos and corrections. The Licensee was provided this report to keep with her files.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00. This report along with a copy of the appeal rights was provided. Exit interview was conducted with Licensee Jessica Delmar.

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Warren Birks
LICENSING EVALUATOR SIGNATURE: DATE: 03/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/23/2022
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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