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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197402459
Report Date: 08/21/2019
Date Signed: 08/21/2019 04:15:34 PM

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:HILLMAN FAMILY DAY CAREFACILITY NUMBER:
197402459
ADMINISTRATOR:HILLMAN, M. & D.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 857-0746
CITY:LOS ANGELESSTATE: CAZIP CODE:
90016
CAPACITY:14CENSUS: 11DATE:
08/21/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Mona HillmanTIME COMPLETED:
04:20 PM
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On 08/21/2019, Licensing Program Analyst (LPA) Karren Starks made an unannounced visit for the purpose of conducting a Case Management Inspection. LPA met with licensee, Mona Hillman who had 11 children in care at the time of inspection. One Grandchild, two Great Grandchildren with the other eight children being unrelated to the licensees. Also present at the time of inspection was co-licensee, Dean Hillman and Assistant, Eric Washington who were observed assisting in supervision of the children in care.

LPA's inspection was to ensure the licensee is complying with the terms of the Non Compliance meeting and maintaining substantial compliance within the facility. LPA observed certificates from additional training licensee has attended. LPA reminded the licensee that when a training is completed to provide the Department with a copy for her file. Licensee agreed.

Based on today's inspection, no deficiencies cited.

Copy of report and Notice of Site Visit issued.
SUPERVISOR'S NAME: Jennie FerreiraTELEPHONE: (424) 301-3067
LICENSING EVALUATOR NAME: Karren StarksTELEPHONE: (424) 301-3069
LICENSING EVALUATOR SIGNATURE:

DATE: 08/21/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2019
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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