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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197410321
Report Date: 09/28/2023
Date Signed: 09/28/2023 05:26:30 PM


Document Has Been Signed on 09/28/2023 05:26 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245



FACILITY NAME:COLEMAN FAMILY CHILD CAREFACILITY NUMBER:
197410321
ADMINISTRATOR:COLEMAN, KNAKHEAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 290-3737
CITY:LOS ANGELESSTATE: CAZIP CODE:
90008
CAPACITY:12CENSUS: 6DATE:
09/28/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:36 PM
MET WITH:Licensee Knakhea ColemanTIME COMPLETED:
05:30 PM
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On 9/28/2023 at 1:40 PM, Licensing Program Analysts (LPA) Maria Rendon met with Licensee, Knakhea Coleman and guided LPA on a tour of the home. The purpose of the visit was an unannounced annual inspection at the home to ensure that health, safety and personal rights as requires by Title 22 and Health and Safety Regulations governing California Child Care Homes will be met. The Family Child Care Home operates Monday-Sunday 6:00 am-5:59 am. LPA observed 6 children, 2 of which are infants, under the care and supervision of Licensee and 01 other staff member.

Due to time constraint LPA will return to the facility to complete an annual required inspection and address deficiencies during LPA's return.

An exit interview was conducted with Licensee Knakhea Coleman and a copy of this report, notice of site visit and appeal rights were provided to Licensee Knakhea Coleman.

SUPERVISOR'S NAME: Rita RamosTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Maria RendonTELEPHONE: 424-301-3023
LICENSING EVALUATOR SIGNATURE:
DATE: 09/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/28/2023
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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