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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191604096
Report Date: 06/01/2023
Date Signed: 06/01/2023 09:46:44 AM


Document Has Been Signed on 06/01/2023 09:46 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
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754



FACILITY NAME:MAYS FAMILY DAY CAREFACILITY NUMBER:
191604096
ADMINISTRATOR:MAYS, BOBBIE J.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 538-8336
CITY:CARSONSTATE: CAZIP CODE:
90746
CAPACITY:12CENSUS: 1DATE:
06/01/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Bobbie MaysTIME COMPLETED:
10:00 AM
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About 9:00AM, Licensing Program Analyst (LPA) T. Tran arrived at the above licensed facility to conduct a POC inspection to follow up on the citations that were cited on 05/10/23. Upon arrival, LPA met with licensee Bobbie Mays, her employee and observed a child in care.

LPA obtained both licensee and her employee Declaration Statement for the POC and reviewed a complete file for employee that was cited on 5/10/2023. Therefore, based on LPA record review POCs has been cleared.

A notice of site visit was given and must remain posted for 30 days.
Exit interview conducted and report was reviewed with the facility representative, Bobbie Mays.
SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Tiffanie TranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 06/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/01/2023
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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