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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197493875
Report Date: 10/07/2021
Date Signed: 10/25/2021 11:45:48 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:FULLER FAMILY CHILD CAREFACILITY NUMBER:
197493875
ADMINISTRATOR:FULLER, MARLOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 505-9749
CITY:LOS ANGELESSTATE: CAZIP CODE:
90047
CAPACITY:14CENSUS: 13DATE:
10/07/2021
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Marlo FullerTIME COMPLETED:
01:50 PM
NARRATIVE
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On 10/7/2021, Licensing Program Analysts (LPAs) Judy Laureano and Lillian Casillas conducted an unannounced Case Management - Deficiencies Inspection. LPAs met with Assistant, Adlean Fuller, and discussed the purpose of the visit. LPAs observed 13 children and 2 staff.

Upon arrival, Assistant stated that Licensee, Marlo Fuller, was “off Thursdays and Fridays.” LPA asked Assistant to call Licensee and request her presence at the facility. Licensee arrived at approximately 1:00 pm.

On 9/10/2021 licensee was not present and it was revealed that the licensee days off are Thursday & Friday. In addition, on Thursday, 8/6/2021 and Thursday, 10/7/2021 licensee was absent from the home. Based on Title 22 absences shall not exceed 20 percent of the hours that the facility is providing care per day. The licensee is in violation of this rule.

LPA issued a Type A deficiency pursuant California Code of Regulations Title 22
(see LIC9099-D for details). Upon receipt of this report, the Director must post the report along with the Notice of Site Visit for 30 days for parents to view. A copy of this report must be provided to parents/guardians of children in care at the facility and parents/guardians of children newly enrolled at the facility of this Type A citation for the next 12 months (1 year).
The report shall be provided, no later than the next business day or the next day that the child is in care. The LIC 9224 Acknowledgement of Receipt of Licensing Reports shall be signed and kept in each of the children’s records. If the Licensee fails to comply an $100.00 civil penalty shall be assessed for each family enrolled and in attendance.



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SUPERVISOR'S NAME: Maureen NealTELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Judy LaureanoTELEPHONE: (424) 301-3060
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 3
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: FULLER FAMILY CHILD CARE
FACILITY NUMBER: 197493875
VISIT DATE: 10/07/2021
NARRATIVE
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PAGE 2

An exit interview was conducted and a copy of this report along with the Notice of Site Visit and Appeal Rights were provided to Licensee.

SUPERVISOR'S NAME: Maureen NealTELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Judy LaureanoTELEPHONE: (424) 301-3060
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2021
LIC809 (FAS) - (06/04)
Page: 3 of 3
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: FULLER FAMILY CHILD CARE
FACILITY NUMBER: 197493875
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/07/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/07/2021
Section Cited

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102417 Operation of a Family Child Care Home (a) Temporary absences shall not exceed 20 percent of the hours that the facility is providing care per day.
This requirement was not met as evidenced by:
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Based on observation and interviews, Licensee is not present at the facility every Thursday and Friday of the week, which poses an immediate Health, Safety or Personal Rights 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: Maureen NealTELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Judy LaureanoTELEPHONE: (424) 301-3060
LICENSING EVALUATOR SIGNATURE:
DATE: 10/07/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/07/2021
LIC809 (FAS) - (06/04)
Page: 2 of 3