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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197493354
Report Date: 01/04/2021
Date Signed: 01/05/2021 12:45:13 PM

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:KAUFMAN FAMILY CHILD CAREFACILITY NUMBER:
197493354
ADMINISTRATOR:KAUFMAN, ANITAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 822-6181
CITY:LOS ANGELESSTATE: CAZIP CODE:
90047
CAPACITY:12CENSUS: 0DATE:
01/04/2021
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME BEGAN:
07:00 PM
MET WITH:Anita Kaufman, LicenseeTIME COMPLETED:
07:15 PM
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On 01/04/2021 at 7:00 PM a Case Management tele-visit was conducted by Sharalyn Jenkins-Sweeten, Regional Manager (RM), Maureen Neal, Licensing Program Manager (LPM) and Sabrina Martinez, Licensing Program Analyst (LPA) for the purpose of serving a Temporary Suspension Order (TSO) to Anita Kaufman, Licensee.

Licensee Anita Kaufman was served with the following by RM Jenkins-Sweeten:

1) Temporary Suspension Order (TSO)
2) Statement to Respondent
3) Government Code Statutes
4) Summary Instructions for Licensee
5) Summary of Charges
6) Accusation
7) Confidential Name List
8) Request for Discovery
9) Notice of Defense

RM Jenkins-Sweeten advised the licensee that she has to inform all the parents concerning the TSO by providing the parents with a Parent Packet that was provided to the licensee during this tele-visit. The licensee was advised that she has fifteen (15) calendar days to respond to the Temporary Suspension Order (TSO) by mailing the Notice of Defense included in the TSO Packet. The Notice of the Temporary Suspension Order (TSO) was posted. Licensee was advised not to remove the sign pending the Administrative Action.
An enhanced civil penalty determination is pending.
SUPERVISOR'S NAME: Maureen NealTELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Sabrina MartinezTELEPHONE: (424) 301-3059
LICENSING EVALUATOR SIGNATURE:

DATE: 01/04/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/04/2021
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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: KAUFMAN FAMILY CHILD CARE
FACILITY NUMBER: 197493354
VISIT DATE: 01/04/2021
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Upon receipt of this report, the report must be posted along with the Notice of Site Visit for 30 days for parents to view. Licensee must inform the parents/guardians of children in care at the facility via form LIC-9224 Acknowledgement of Receipt of Licensing Reports.

An exit interview was conducted and a copy of this report and appeal rights are being emailed to licensee and LPA explained that a reply to the email shall be considered a substitute for the hard-copy signature.
SUPERVISOR'S NAME: Maureen NealTELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Sabrina MartinezTELEPHONE: (424) 301-3059
LICENSING EVALUATOR SIGNATURE:

DATE: 01/04/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/04/2021
LIC809 (FAS) - (06/04)
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