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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197417120
Report Date: 07/19/2021
Date Signed: 07/19/2021 11:50:06 AM

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:WILLIAMS FAMILY CHILD CAREFACILITY NUMBER:
197417120
ADMINISTRATOR:WILLIAMS, GERALDFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 637-1109
CITY:COMPTONSTATE: CAZIP CODE:
90220
CAPACITY:14CENSUS: 5DATE:
07/19/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Gerald Williams- LicenseeTIME COMPLETED:
11:00 AM
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This is an unannounced Case Management Inspection visit conducted on 07/19/2021 10:30 am by Alicia Bailey Licensing Program Analyst (LPA). LPA met with Licensee Gerald Williams regarding the usual incident report received in the office on 12/24/2020. LPA and Licensee Williams toured the facility, at the time of the inspection all ratios were in compliance.

The report stated that on 12/24/2020 one person (Licensee Williams) tested positive for Covid-19. Licensee receive positive test result on 12/18/2020. Licensee Williams contacted Crystal Stairs, clean and sanitize the facility. The notice was posted at the facility and sent out to the parents. The facility was close from 12/18/2020 thru 01/04/2021.

Based on today’s inspection, and interviews conducted, the facility followed the appropriate reporting requirements, Notified Parents, no follow-up is necessary regarding the incident. Licensee Williams followed the required protocol for reporting requirements" as the incident was reported to Child Care Licensing. It does not appear this incident was the result of a Title 22 violation and the facility followed the appropriate regulations to care for the children in care. No deficiencies were cited on this date.
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Alicia BaileyTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2021
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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