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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494476
Report Date: 09/13/2021
Date Signed: 09/14/2021 08:53:03 AM

Document Has Been Signed on 09/14/2021 08:53 AM - 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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:SIMPSON FAMILY CHILD CAREFACILITY NUMBER:
197494476
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
09/13/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Elexus SimpsonTIME COMPLETED:
03:45 PM
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On 9/2/2021 at 1:10PM, Licensing Program Analysts (LPA) Lillian Casillas and Deborah Lowe attempted to conduct an unannounced Case Management – Incident for the purpose of following up on an Unusual Incident Report (UIR) submitted on 8/19/2021. LPAs met with Licensee, Elexus Simpson, via the Ring doorbell who stated she was out picking up kids from school and would not return home until 3:45PM.

On 9/13/2021 at 3:30PM, Licensing Program Analyst (LPA) Lillian Casillas conducted an unannounced Case Management – Incident teleconference inspection for the purpose of following up on an Unusual Incident Report (UIR) submitted on 8/19/2021. LPA met with Licensee, Elexus Simpson.

According to the UIR, Licensee stated that the outdoor play area in the backyard will be off-limits neighbors (located at 3439 W. 76th Street) are rebuilding the garage. The neighbor’s garage is accessible via the Licensee’s backyard. Licensee stated the end date for the construction is unknown. Outdoor care and supervision will be provided at the Fox Hills Park (Green Valley Circle & Buckingham Pkwy, Culver City) from 2:00-4:00PM. Per Licensee, parent authorization/consent was provided.



During the investigation, LPA interviewed the Licensee who stated construction was completed on 9/10/2021 and neighbors added a divider wall. Licensee stated the backyard is now safe for children to use.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies are cited.

An exit interview was conducted and a copy of this report (LIC 809) were provided to Licensee. Licensee agreed to reply to this email in lieu of a signature.
SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Lillian J Casillas
LICENSING EVALUATOR SIGNATURE: DATE: 09/02/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/02/2021
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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