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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 192011040
Report Date: 02/14/2020
Date Signed: 02/14/2020 11:04:52 AM

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:DAVIS FAMILY CHILD CAREFACILITY NUMBER:
192011040
ADMINISTRATOR:DAVIS, APRILFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 988-1193
CITY:LOS ANGELESSTATE: CAZIP CODE:
90047
CAPACITY:14CENSUS: 2DATE:
02/14/2020
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:April Davis, LicenseeTIME COMPLETED:
11:30 AM
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On 02/14/2020 at 10:45am, Licensing Program Analyst (LPA) Adrian Risher conducted an unannounced Plan of Correction inspection to determine if the deficiencies cited on 01/09/2020 have been cleared. LPA met with April Davis, Licensee and toured the facility. There were 2 children present at the time of the inspection and 1 assistant.

Licensee was cited for not having a fire drill log and updated cpr card. Licensee previous submitted a copy of updated cpr card to LPA Lord-Richard on 01/09/2020. Licensee provided LPA with a copy of fire drill log during today's inspection. Licensee stated that she previously submitted the documents to LPA Lord-Richard via email.

Licensee has submitted the documentation to clear plan of correction.

Exit interview was conducted and a copy of the report was provided. Appeal rights were reviewed and provided.

SUPERVISOR'S NAME: Victor BautistaTELEPHONE: (424) 301-3008
LICENSING EVALUATOR NAME: Adrian RisherTELEPHONE: (424) 301-3050
LICENSING EVALUATOR SIGNATURE:

DATE: 02/14/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2020
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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