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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197415094
Report Date: 01/28/2020
Date Signed: 01/30/2020 10:15:26 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:CHAPPELL FAMILY CHILD CAREFACILITY NUMBER:
197415094
ADMINISTRATOR:CHAPPELL, RAYSHAUNFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 973-8064
CITY:HAWTHORNESTATE: CAZIP CODE:
90250
CAPACITY:14CENSUS: 3DATE:
01/28/2020
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
09:36 AM
MET WITH:Rayshaun Chappell, LicenseeTIME COMPLETED:
10:27 AM
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Mary Ruiz, Licensing Program Manager (LPM) and Shandra Powell, Licensing Program Analyst (LPA), conducted an unannounced visit to the family child care home, on 01/30/2020, for the purpose of delivering the report of the below Supervisory Conference meeting held in the El Segundo Regional Office on 01/28/2020. LPM and LPA were greeted by Rayshaun Chappell, a tour of the facility was conducted and census were taken.
Present at the meeting on 01/28/2020 were: Mary Ruiz, LPM, Shandra Powell, LPA, and Rayshaun Chappell, Licensee. LPM addressed concerns the Department has with the operation of the facility.

LPM Ruiz discussed the purpose of this meeting with the licensee and advised that the Supervisory Conference is the first step of the Administrative process. If licensee continues to violate licensing regulations, the case may escalate to a Non-Compliance Conference and possible Revocation Action.

LPM discussed the facility's visit history and discussed the Departments concerns. LPM addressed the following issues during the meeting discussion:

Licensee not residing in home - Licensee stated he does reside in the home and that he rents the home from his mother. Per LIC 812 dated 10/03/2018 Declaration signed by Licensee is on file.



Lack of Care and Supervision - Staff left children unattended consequently inappropriate contact between children occurred, in the back yard of the home such as leaving children alone in the backyard where children hide behind a playhouse while engaging in inappropriate child's play.
SUPERVISOR'S NAME: Mary RuizTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Shandra PowellTELEPHONE: (323) 981-3383
LICENSING EVALUATOR SIGNATURE:

DATE: 01/28/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2020
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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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: CHAPPELL FAMILY CHILD CARE
FACILITY NUMBER: 197415094
VISIT DATE: 01/28/2020
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PLAN: The Department will place the facility on Require Visits to monitor the facility for 1 year to conduct more visits within that year to ensure compliance with the regulations are met. Licensee is to attend an Orientation on March 10, 2020 at 8:00 a.m.. Also, the Department is recommending the Technical Support Program referral to the licensee.

The meeting was concluded and a copy of this report was provided to the licensee on this date.
SUPERVISOR'S NAME: Mary RuizTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Shandra PowellTELEPHONE: (323) 981-3383
LICENSING EVALUATOR SIGNATURE:

DATE: 01/29/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2020
LIC809 (FAS) - (06/04)
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