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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198005535
Report Date: 01/29/2020
Date Signed: 01/29/2020 03:48:28 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:JEFFERS FAMILY CHILD CAREFACILITY NUMBER:
198005535
ADMINISTRATOR:JEFFERS, LINDAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 626-9149
CITY:LONG BEACHSTATE: CAZIP CODE:
90808
CAPACITY:14CENSUS: 11DATE:
01/29/2020
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
03:16 PM
MET WITH:Kimberly PiferTIME COMPLETED:
04:03 PM
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A Plan of Correction inspection was conducted by Licensing Program Analyst (LPA) Timothy Fields. LPA met with Assistant Kimberly Pifer. Licensee Linda Jeffers was not present during todays inspection. The purpose of todays inspection was to ensure licensee was in compliance with the following deficiencies cited on 01/10/20:
  1. 102417(g) Operations of a Family Child Care home.
  2. 102421(b) Child's Record.
  3. 102417(g)(1) Operations of a Family Child Care home.
LPA observed a screen barricading the fireplace. There were no saucer chair, baby bouncers, or rockers observed in the home. Children records were reviewed and observed to be complete with required documentation on this date. The facility was observed to be in compliance with the above regulations.

An exit interview was conducted with Assistant Kimberly Pifer. A copy of the report along with a notice of site visit was provided.
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Timothy FieldsTELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:

DATE: 01/29/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2020
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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