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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
197493885
Report Date:
11/08/2019
Date Signed:
11/08/2019 02:34:09 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:
HAYES FAMILY CHILD CARE
FACILITY NUMBER:
197493885
ADMINISTRATOR:
HAYES, TONI
FACILITY TYPE:
810
ADDRESS:
TELEPHONE:
(323) 335-9622
CITY:
LOS ANGELES
STATE:
CA
ZIP CODE:
90047
CAPACITY:
14
CENSUS:
5
DATE:
11/08/2019
TYPE OF VISIT:
Case Management - Other
UNANNOUNCED
TIME BEGAN:
02:30 PM
MET WITH:
Toni Hayes, Licensee
TIME COMPLETED:
02:45 PM
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Licensing Program Analyst (LPA) Sophia Lord-Richard observed the backyard to be clean and usable by children in care. The backyard is now accessible. Licensee provided LPA a new Declaration.
SUPERVISOR'S NAME:
Sharalyn Jenkins-Sweeten
TELEPHONE:
(424) 301-3054
LICENSING EVALUATOR NAME:
Sophia Lord-Richard
TELEPHONE:
(424) 301-3060
LICENSING EVALUATOR SIGNATURE:
DATE:
11/08/2019
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
11/08/2019
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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