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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197495061
Report Date: 02/07/2023
Date Signed: 02/07/2023 11:10:07 AM

Document Has Been Signed on 02/07/2023 11:10 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:DIXON FAMILY CHILD CAREFACILITY NUMBER:
197495061
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 8DATE:
02/07/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Tabina Dixon, LicenseeTIME COMPLETED:
10:15 AM
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On 2/7/2023 at 9:13am, Licensing Program Analyst Adrian Risher conducted a case management visit for increased monitoring. LPA met with Tabina Dixon, Licensee. LPA explained the purpose of the visit. LPA observed 8 children in care with 1 staff.

LPA Risher requested an update on her primary residence. LPA Risher confirmed that she started the process to move the Resource Family Home to the Family Child Care Home residence.

Licensee provided a signed copy of the Noncompliance Conference Summary from the meeting that was held on 1/20/2023. Licensee provided the written declaration confirming the Reporting Requirements and Criminal Record Clearances videos were watched.

Based on observations made by the LPA, no deficiencies will be cited today. LPA did not observe any violations during today's visit. Facility will continue to be under increased monitoring on a quarterly basis.

Exit interview was completed with Tabina Dixon, Licensee. Appeal Rights will be provided. A Notice of Site Visit will be provided.
SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Adrian Risher
LICENSING EVALUATOR SIGNATURE: DATE: 02/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/07/2023
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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