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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197415280
Report Date: 06/24/2021
Date Signed: 06/24/2021 12:54:10 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:GRANT FAMILY CHILD CAREFACILITY NUMBER:
197415280
ADMINISTRATOR:GRANT, MICHELAEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(424) 246-1143
CITY:COMPTONSTATE: CAZIP CODE:
90220
CAPACITY:14CENSUS: 0DATE:
06/24/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:35 PM
MET WITH:Michelae Grant- LicenseeTIME COMPLETED:
01:35 PM
NARRATIVE
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Licensing Program Analyst Alicia Bailey made unannounced case management inspection on 06/24/2021. LPA met with Licensee Grant and explain the nature of the visit. LPA informed Licensee Grant the facility fees are delinquent in the amount of $ 560.00. (An applicant or licensee shall be charged fees as specified in Health and Safety Code Section 1596.803). Licensee Grant stated due to economic hardship she was unable to pay the facility fees. Licensee Grant stated once she receives stipend money from state of California or Crystal Stairs Licensee will pay the delinquent facility fees. LPA Bailey advised Licensee Grant if facility fees are not paid by POC date, the department will take administrative action.

Licensee Grant stated she fully understood the requirement and would be submitting a payment to the Department by the POC date

Exit interview was conducted with Licensee Grant this report was read and explained to licensee. This report and deficiency report appeal rights and Notice of Site Visit were provided during the visit

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00

SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Alicia BaileyTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 06/24/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2021
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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: GRANT FAMILY CHILD CARE
FACILITY NUMBER: 197415280
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/24/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/24/2021
Section Cited

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Licensing Fees
An applicant or licensee shall be charged fees as specified in Health and Safety Code Section 1596.803

The requirement is not met as evidenced by: Per LIS, Licensee owes fees. This is a potential risk to children in care.

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Alicia BaileyTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 06/24/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/24/2021
LIC809 (FAS) - (06/04)
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