<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197493493
Report Date: 10/19/2021
Date Signed: 10/19/2021 12:14:06 PM

Document Has Been Signed on 10/19/2021 12:14 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:HILL FAMILY CHILD CAREFACILITY NUMBER:
197493493
ADMINISTRATOR:JILL HILLFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 439-9311
CITY:COMPTONSTATE: CAZIP CODE:
90222
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 6DATE:
10/19/2021
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Elisha Terry; LICENSEE ASSTTIME COMPLETED:
12:25 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
Licensing Program Analyst (LPA) Reiko Jones-Modeste conducted an unannounced Plan of Correction visit to address deficiencies cited on September 9, 2021. LPA observed two Licensee Assistants and six children in care at 10:45am. All adults are criminally cleared and associated to the facility.

The following cited deficiencies have not been corrected:
· Mandated Reporter certification for S3

LPA observed and reviewed the following corrections:

· Chemicals and detergents inaccessible with Child Safety locks on laundry closet
· Staff Immunizations (Tb) for S2 and S3
· Fire extinguisher proof of annual service September 2021
· Disaster Drill log posted and available
· Facility roster not observed and available
· Mandated Reporter certification for S1. S2

Based on the LPA observation and record review, the following deficiencies listed on the attached LIC 809 (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited must be cleared to protect the children’s health & safety.
LPA advised LICENSEE to address the Corrections no later than October 22, 2021 as an additional Proof of Correction inspection will be scheduled.
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Reiko Jones
LICENSING EVALUATOR SIGNATURE: DATE: 09/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/23/2021
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 3
Document Has Been Signed on 10/19/2021 12:14 PM - It Cannot Be Edited


Created By: Reiko Jones On 10/19/2021 at 11:46 AM
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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: HILL FAMILY CHILD CARE
FACILITY NUMBER: 197493493

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/19/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/22/2021
Section Cited
HSC
1596-8662

1
2
3
4
5
6
7
Mandated Reporter
Availability of information regarding detecting and reporting child abuse and neglect; training for mandated reporter who is licensed day care provider, administrator, or employee of a licensed child day care facility; proof of completion.
1
2
3
4
5
6
7
LICENSEE understands proof of correction must be provided by POC due date via email or inspection.
www.mandatedreporterca.com
8
9
10
11
12
13
14
Based on LPAs record review this requirement has not been met as evidenced by no Mandated Reporter Certification. available for S3 provided. This poses a potential risk to the health and safety of children in care.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
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:Karen Chambers
LICENSING EVALUATOR NAME:Reiko Jones
LICENSING EVALUATOR SIGNATURE:
DATE: 10/19/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/19/2021


LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: HILL FAMILY CHILD CARE
FACILITY NUMBER: 197493493
VISIT DATE: 10/19/2021
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
26
27
28
29
30
31
32
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 reprehensive. Failure to maintain posting as required will result in a civil penalty of $100.00.
Exit interview was conducted with LICENSEE. Appeal Rights procedures distributed and explained.
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Reiko Jones
LICENSING EVALUATOR SIGNATURE:

DATE: 10/19/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2021
LIC809 (FAS) - (06/04)
Page: 3 of 3