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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198010536
Report Date: 06/14/2024
Date Signed: 06/14/2024 03:20:07 PM


Document Has Been Signed on 06/14/2024 03:20 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754



FACILITY NAME:TILLMAN FAMILY CHILD CAREFACILITY NUMBER:
198010536
ADMINISTRATOR:TILLMAN, TRACEYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 209-8686
CITY:LOS ANGELESSTATE: CAZIP CODE:
90061
CAPACITY:14CENSUS: 1DATE:
06/14/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Licensee Tracey TillmanTIME COMPLETED:
03:30 PM
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On June 14, 2024 at 1:30 pm, Licensing Program Analyst (LPA) Angelica Wallin, conducted an unannounced Annual Required Inspection and was met by Licensee, Tracey Tillman. Hours of operation are 24 hours for 7 days a week as needed. LPA advised licensee cannot exceed the 23 hour limit of day care operations. LPA toured the home inside and outside and a census was taken.

This one - story home consists of 1 bedroom and 2 bathrooms. Areas used by children include living room as the day care room, one bathroom, front yard and back yard. Per Licensee, areas off limits to children and parents include: one bedroom, one bathroom, kitchen, kitchenette and the garage. There is one child present during time of inspection. Licensee stated that there are currently nine children enrolled in the facility.

The home was inspected for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children. LPA noted space with age-appropriate toys. There is a working smoke and carbon monoxide detector. During inspection, LPA observed fire extinguisher with purchase tag of 3/2023. Per licensee, she previously purchased a two-pack fire extinguisher and recently put up one of the fire extinguishers that was not used last year. LPA discussed with licensee regarding Title 22 regulations regarding fire extinguishers. A technical violation citation issued. During inspection, LPA observed cleaning supplies and chemicals located in child proof locked cabinet in kitchen under the sink. LPA observed knives located in kitchen cabinet on a high shelf inaccessible to children in care. According to the applicant, there are no weapons or firearms at the home; LPA did not observe any firearms or weapons at the time of the inspection.

Per licensee, outdoor play conducted in the front and back yard. Per licensee, outdoor play will be conducted either in the front yard or the back yard. Per licensee, yards are not used at the same time. LPA observed front and back yard is gated and contains no hazardous items that can pose a danger to children. LPA advised licensee that total supervision to be maintained at all times during outdoor play.

SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 854-7636
LICENSING EVALUATOR NAME: Angelica WallinTELEPHONE: (626) 366-3613
LICENSING EVALUATOR SIGNATURE:
DATE: 06/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/14/2024
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
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: TILLMAN FAMILY CHILD CARE
FACILITY NUMBER: 198010536
VISIT DATE: 06/14/2024
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LPA observed there no swimming pool or bodies of water. Per licensee, food service, transportation, and overnight care is provided. Per licensee, overnight care is conducted in the living room. Per licensee, sofa bed in the living room is used as space for overnight care for licensee while children are on cots in the living room. LPA discussed with licensee regarding complete safety and supervision when conducting transportation services.

During inspection, one child’s record was reviewed and observed to be updated and maintained. A review of staff records indicates that licensee has the following updated certificates: mandated reporter certificates with expiration date of 6/2026, updated CPR/1st aid certificate with expiration date of 5/2026 and updated immunization records on file for measles, pertussis, influenza and TB clearance. LPA reviewed the following documentation to be kept in facility: facility license, LIC610A, facility fire drill logs, PUB 394, and LIC9040.

Licensee Tillman was advised that regulation prohibits the smoking of tobacco in a private residence licensed as a family childcare home during the hours of operation. LPA reviewed with Licensee Tillman items prohibited in FCCH, no baby bouncers, no infant walkers, No Johnny jumpers, no saucer chairs, and any other item that falls into that category are not permitted in the facility.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.



This facility does not provides Incidental Medical Services – IMS. Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department.
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 854-7636
LICENSING EVALUATOR NAME: Angelica WallinTELEPHONE: (626) 366-3613
LICENSING EVALUATOR SIGNATURE:

DATE: 06/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2024
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
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: TILLMAN FAMILY CHILD CARE
FACILITY NUMBER: 198010536
VISIT DATE: 06/14/2024
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The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-carelicensing/subscribe and select the Child Care option to receive email communication.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

During inspection, LPA observed the following items that needed to be addressed from previous LIC 809 case management report issued on 4/5/24:
  • Construction in the living room as the day care play area and nap area, dining area, kitchen, bathroom, and laundry room to be completed
  • Light fixtures in ceiling to be installed, electrical outlets to be covered, flooring to be addressed, and all walls to be painted
  • All construction tools used such as: wood panels, hammer, saw, nails, power drills, package of mixing compound, pack of fiber glass batts, extension cords etc. to be removed once construction is completed

LPA observed all items listed above completed and addressed. No deficiencies cited at this time. Facility is in compliance California Title 22 Regulations. Exit interview conducted and report was reviewed with licensee, Tracey Tillman. During the exit interview, the licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS. A notice of site visit was given and must remain posted for 30 days.
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 854-7636
LICENSING EVALUATOR NAME: Angelica WallinTELEPHONE: (626) 366-3613
LICENSING EVALUATOR SIGNATURE:

DATE: 06/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2024
LIC809 (FAS) - (06/04)
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