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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197402459
Report Date: 07/15/2021
Date Signed: 07/21/2021 10:48:09 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: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: 6DATE:
07/15/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Mona HillmanTIME COMPLETED:
02:00 PM
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On 7/15/2021 at 12:00 P.M. Licensing Program Analyst (LPA) Chandler made an unannounced visit to the Hillman Family Child Care home for the purpose of conducting a Required-1 year/Random Annual visit. Upon arrival LPA was greeted by licensee Mona Hillman, LPA was informed that due to covid 19 related reasons a tour of the home would not be granted. Licensee suggested that she would bring all requested documents and other inspection requirements to the door.

LPA explained to licensee that due to her reasoning not to allow LPA to exercise the departments inspection authority that she could be cited for civil penalties and that children should not be present in the home and parents shall be called to pick up their children. After further explanation LPA was allowed to inspect all identified day care activity areas

Licensee had 6 children in care, licensee states that the only persons present in the home were the children in care, her husband and herself. No other persons were present, specifically the excluded individual.

The following was observed:
Current roster
First Aid Kit with the required supplies; scissors, bandages; antibacterial ointments, thermometer and tweezers.
Smoke detector was observed
Children's files were reviewed and appeared to be up to date
A 2 series of above fire extinguisher
Children were observed eating lunch in the living room area of the home
SUPERVISOR'S NAME: Peter FloresTELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Jillinda ChandlerTELEPHONE: (424) 301-3068
LICENSING EVALUATOR SIGNATURE:

DATE: 07/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2021
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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: HILLMAN FAMILY DAY CARE
FACILITY NUMBER: 197402459
VISIT DATE: 07/15/2021
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The living room was inspected childrens toys and materials were observed in fair condition
Fire drill was last conducted 6/ 2021
The dining room was inspected, no hazardous conditions were observed
The restroom was observed; no toxins or detergents were present
The kitchen was observed; no present hazards were observed
Licensee states that there are no firearms or weapons in the home, none were observed.
The outdoor activity area was observed fully gated
No pools or bodies of water were present

An exit interview was conducted and a copy of the report was provided to the licensee

No citations were issued during todays visit.
SUPERVISOR'S NAME: Peter FloresTELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Jillinda ChandlerTELEPHONE: (424) 301-3068
LICENSING EVALUATOR SIGNATURE:

DATE: 07/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2021
LIC809 (FAS) - (06/04)
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