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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019364
Report Date: 10/19/2023
Date Signed: 10/19/2023 09:42:55 AM

Document Has Been Signed on 10/19/2023 09:42 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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:GRAHAM FAMILY CHILD CAREFACILITY NUMBER:
198019364
ADMINISTRATOR:FALLON TIANA GRAHAMFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 500-5600
CITY:DIAMOND BARSTATE: CAZIP CODE:
91765
CAPACITY: 14TOTAL ENROLLED CHILDREN: 19CENSUS: 8DATE:
10/19/2023
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME BEGAN:
08:44 AM
MET WITH:Jiovondra Cullins & Fallon GrahamTIME COMPLETED:
09:42 AM
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Case management inspection conducted by Licensing Program Analysts (LPA) Jennifer Hua and Veronica Martinez-Garza. The purpose of the quarterly inspection is due to the Non-Compliance that was held on 3/24/2023. Upon arrival, LPAs met with assistants Jiovondra Cullins and Jordan Brown. The purpose of the visit was announced. Per assistant Cullins, licensee is out dropping off children to school. At 8:45am, LPAs toured the facility and observed 8 children in care, 4 of whom are infants. Children were supervised by 2 assistants. At around 8:48am, licensee arrived and stated she was out dropping off school-age children to schools.

During the visit, the following were observed and reviewed: Children were in the day care room, no napping children/infant. LPAs observed 2 play yards, one in the living room and one in the day care room, staff and children files reviewed, roster reviewed, drill log observed. Fire drill was conducted on 10/6/23 and earthquake drill was conducted on 9/10/23, personal rights of children and staffing ratio and capacity were met.

Children records reviewed, reflected that child #5, #7 and #8 lack form LIC9224s in their file. Per licensee, parents have not returned them and children have not been coming consistently. Licensee will email/drop off to LPA by 10/20/23. Per licensee, moving forward, will ensure that all paperwork are in place a week prior to child's start date.

Based on review and observation, no deficiency cited during this visit.

An exit interview conducted with licensee, Fallon Graham. Notice of Site Visit form was provided and must be posted for 30 days or a civil penalty of $100 shall be assessed.
SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Jennifer Hua
LICENSING EVALUATOR SIGNATURE: DATE: 10/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/19/2023
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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