Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191670506
Report Date: 09/19/2017
Date Signed 09/19/2017 09:52:42 AM

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:ARTESIA HIGH SCHOOL CHILDREN'S CENTERFACILITY NUMBER:
191670506
ADMINISTRATOR:ARLENE RIDDICKFACILITY TYPE:
850
ADDRESS:20651 NORWALK BLVDTELEPHONE:
(562) 229-7959
CITY:LAKEWOODSTATE: CAZIP CODE:
90715
CAPACITY:104CENSUS: 24DATE:
09/19/2017
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:59 AM
MET WITH:Arlene RiddickTIME COMPLETED:
09:52 AM
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Licensing Program Analyst (LPA) Warren Birks, conducted an unannounced case management inspection for the purpose of providing and retrieving time sensitive fingerprint clearance documents. This was done as a courtesy as LPA did not retrieve documents during the August 31, 2017 inspection.

Exit interview conducted with Director Arlene Riddick.

SUPERVISOR'S NAME: Katherine HarewoodTELEPHONE: (323) 981-2956
LICENSING EVALUATOR NAME: Warren BirksTELEPHONE: 323-981-3373
LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2017
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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