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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191594940
Report Date: 08/18/2022
Date Signed: 08/18/2022 12:52:13 PM


Document Has Been Signed on 08/18/2022 12:52 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:COLBERT FAMILY DAY CAREFACILITY NUMBER:
191594940
ADMINISTRATOR:COLBERT, LEE ETTAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 213-9767
CITY:LYNWOODSTATE: CAZIP CODE:
90262
CAPACITY:14CENSUS: 4DATE:
08/18/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Lee Colbert, LicenseeTIME COMPLETED:
01:15 PM
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On 08/18/2022 at 11:30 AM, Licensing Program Analyst (LPA) Katrina Chicote conducted an unannounced inspection for the above facility for the purpose of a Case Management - Other inspection. LPA met with Licensee, Lee Colbert. Also present at the facility was Licensee's Assistant (A1), who has criminal record clearance and associated to facility. LPA observed four children in care, three of them infants, at time of inspection. LPA singularly toured the facility both indoors and outdoors.

During visit LPA discussed with Licensee recent Non-Compliance Conference and reports that were received by The Department that required signature but were unsigned. Licensee states that she did not agree with information on report as a reason for not providing signatures and submitted an appeal. LPA confirmed appeal was received by The Department. LPA discussed Non-Compliance Contract with Licensee during visit and if she wanted to move forward with the stipulations stated on the contract. LPA observed Licensee Lee Colbert sign Non-Compliance Contract during visit. Licensee also stated that she would participate in TSP and provided a copy of the TSP Facility Engagement Participation Agreement that was signed on 07/16/2022.
LPA observed the following Proof of Corrections during visit from Deficiencies cited on 05/03/2022:
  • At 12:03 PM, LPA observed pool door locked with a pad lock requiring key (photo taken).
  • At 12:04 PM, LPA observed chimney barricaded with an operable child safety lock (photo taken).
  • At 12:05 PM, LPA observed wall floor vent screen to have barricade (photo taken).
  • At 12:05 PM, LPA observed play yards to be free of loose items and nothing hanging above. LPA also discussed safe sleep regulations with Licensee during visit.
  • At 12:30 PM, LPA observed all four children have immunization records in their files at time of inspection.
  • At 12:34 PM, LPA observed updated children's roster at time of inspection (photo taken).

Report Continues - Page 1 of 2
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina ChicoteTELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:
DATE: 08/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/18/2022
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 2


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: COLBERT FAMILY DAY CARE
FACILITY NUMBER: 191594940
VISIT DATE: 08/18/2022
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The facility was found in compliance per Title 22 regulations, there will be no deficiencies cited today, 08/18/2022.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview was conducted and report was reviewed with the Licensee (or facility representative), Lee Colbert.


Report Ends - Page 2 of 2
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina ChicoteTELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:

DATE: 08/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2022
LIC809 (FAS) - (06/04)
Page: 2 of 2