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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198012311
Report Date: 10/20/2022
Date Signed: 10/20/2022 04:44:27 PM


Document Has Been Signed on 10/20/2022 04:44 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754



FACILITY NAME:DUCKETT FAMILY CHILD CAREFACILITY NUMBER:
198012311
ADMINISTRATOR:DUCKETT, YOLANDAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 232-0727
CITY:LOS ANGELESSTATE: CAZIP CODE:
90011
CAPACITY:14CENSUS: 9DATE:
10/20/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
04:30 PM
MET WITH:Yolanda Duckett, LicenseeTIME COMPLETED:
05:00 PM
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Licensing Program Analyst Mayra Rivera conducted an unannounced Case Management Inspection. LPA met with Licensee Yolanda Duckett who guided the LPA on a tour of the facility.

Based on file review observation and information provided by Licensee, Licensee Yolanda Duckett Pediatric First Aid/ CPR certification expired on 7/21/22.

Based on the available information it is a result of a Title 22 violation for not having the updated required Pediatric First Aid/ CPR certification. The facility has been given a technical violation for the expired Pediatric First Aid/ CPR certification. Licensee Yolanda and Assistant Bobbie have enrolled for the Pediatric First Aid/CPR course dated October 22, 2022.

The content of this report was read and discussed and an exit interview was conducted with Licensee Yolanda Duckett and the notice of site visit must be posted for 30 days upon receipt and appeal rights were given and explained.
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 981-3368
LICENSING EVALUATOR NAME: Mayra RiveraTELEPHONE: (323) 629-7782
LICENSING EVALUATOR SIGNATURE:
DATE: 10/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/20/2022
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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