Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198017951
Report Date: 11/17/2017
Date Signed 11/17/2017 03:23:12 PM

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:GRANDVIEW HOUSE PRESCHOOLFACILITY NUMBER:
198017951
ADMINISTRATOR:HAIEK, LENAFACILITY TYPE:
850
ADDRESS:1212 N. PACIFIC AVE.TELEPHONE:
(818) 245-6963
CITY:GLENDALESTATE: CAZIP CODE:
91202
CAPACITY:60CENSUS: DATE:
11/17/2017
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
02:20 PM
MET WITH:Lena HaiekTIME COMPLETED:
03:15 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
An Office meeting was held today to discuss the Compliance Plan dated 11/17/2017. Present at this meeting was the Licensee, Lena Haiek and Licensee’s spouse Louis Haiek, also present was Regional Manager, Bertha Manzanares, Licensing Program Manager, Claudia Guangorena, & Licensing Program Analyst, Rita Ramos.

The purpose for the meeting was to address the following citation:
· Limitation & Capacity & Ambulatory Status cited on 11/15/07 & 10/30/17
· Child Care Center Qualifications and Duties cited on 06/29/15
· Teacher Qualification & Duties cited on 06/25/15
· Personnel Requirement cited on 06/29/15

Licensee also submitted an application for Grandview House at The Village #19801959 on 08/18/17; the application is pending. Licensee was advised she is not able to operate the day-care facility for Grandview House At The Village located at 1435 Kenneth Road, Glendale, CA 91201 until the facility is licensed.

The Department entered into a Compliance Contract with Licensee Lena Haiek to ensure Licensee remains in complaint with Title 22 Regulations specifically Limitation & Capacity Ambulatory Status. Compliance Contract was signed by Licensee on today’s date November 17, 2017.

The Licensee has been placed on Required visits for 3 years. The licensee has been advised that the Department will conduct more frequent visits to the facility in the next three years to ensure compliance.

Licensee was advised to review our website www.ccld.ca.gov to remain in compliance and review quarterly updates.
Exit interview conducted with licensee, Lena Haiek who is in agreement with the above.
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3395
LICENSING EVALUATOR NAME: Rita RamosTELEPHONE: (323) 981-3985
LICENSING EVALUATOR SIGNATURE:

DATE: 11/17/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2017
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 1