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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191511402
Report Date: 02/25/2025
Date Signed: 02/25/2025 01:36:38 PM

Document Has Been Signed on 02/25/2025 01:36 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:GRAHAM FAMILY DAY CAREFACILITY NUMBER:
191511402
ADMINISTRATOR/
DIRECTOR:		GRAHAM, GAILFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(909) 620-0737
CITY:POMONASTATE: CAZIP CODE:
91767
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: DATE:
02/25/2025
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:00 PM
MET WITH:Licensee Gail GrahamTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
NARRATIVE
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Licensing Program Analyst (LPA) Stephanie Li conducted an unannounced Case Management inspection for deficiencies observed. A risk assessment was conducted. LPA met with Licensee, Gail Graham to whom the reason for the visit was explained. Present was licensee, co- licensee, assistant and 7 children.

During annual visit on 2/10/25, LPA observed mandated reporter certificates that were dated to have been completed in the future July 2026 and observed the layout and design of the certificate was the older version. During visit on 2/10/25, LPA advised and pointed out that the certificate is not accurate and provided website mandatedreporterca.com to licensee and advised for licensee, co-licensee, and all assistants to complete the newer training. LPA also advise that the training has changed and the certificate has changed.

On 2/20/25, Co-Licensee Randall Graham emailed 4 false mandated reporter certificates to LPA’s email dated for 2/10/25, 2/11/25, 2/12/25, and 2/13/25 printed on the old certificate style on a vertical layout.

Based on Licensing staff observations, the following deficiencies listed on the attached LIC 809D (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health and safety.

Licensing staff informed licensee a copy of this licensing report dated 02/25/2025 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

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SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Stephanie Li
LICENSING EVALUATOR SIGNATURE: DATE: 02/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/25/2025
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: GRAHAM FAMILY DAY CARE
FACILITY NUMBER: 191511402
VISIT DATE: 02/25/2025
NARRATIVE
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A notice of site visit was given and must remain posted for 30 days as there are immediate risk(s) to the health, safety, or personal rights of children in care.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.



Exit interview conducted and report was reviewed with Licensee Gail Graham. Appeal Rights were provided and discussed.

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SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Stephanie Li
LICENSING EVALUATOR SIGNATURE:

DATE: 02/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 02/25/2025 01:36 PM - It Cannot Be Edited


Created By: Stephanie Li On 02/25/2025 at 01:09 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: GRAHAM FAMILY DAY CARE
FACILITY NUMBER: 191511402

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/25/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/26/2025
Section Cited
CCR
102402(a)(3)

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Conduct in the operation or maintenance of a family day care home which is inimical to the health, morals, welfare, or safety of either an individual in or receiving services from the facility or the people of the State of California.
This requirement was not met evidenced by:
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Per licensee, she will have herself, co-licensee, and 2 assistants complete the new mandated reporter training and email certificates to LPA's email by 2/26/25.
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Based on observation and record review, all required mandated reporter training certificates were falsified and sent to LPA's email, which poses an immediate health and safety risk to children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Christina Gabelman
LICENSING EVALUATOR NAME:Stephanie Li
LICENSING EVALUATOR SIGNATURE:
DATE: 02/25/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/25/2025


LIC809 (FAS) - (06/04)
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