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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198015371
Report Date: 05/20/2024
Date Signed: 05/20/2024 04:29:37 PM


Document Has Been Signed on 05/20/2024 04:29 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754



FACILITY NAME:BAILEY FAMILY CHILD CAREFACILITY NUMBER:
198015371
ADMINISTRATOR:BAILEY, KIMFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 369-6494
CITY:LA PUENTESTATE: CAZIP CODE:
91744
CAPACITY:14CENSUS: 8DATE:
05/20/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
03:35 PM
MET WITH:Kim BaileyTIME COMPLETED:
04:35 PM
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On 5/20/2024 at 3:35 pm, Licensing Program Analyst (LPA), Carolyn Tuba conducted an unannounced POC (plan of correction) inspection to ensure the deficiency cited on 4/22/2024 during an annual visit has been corrected. A COVID risk assessment was conducted. LPA met with Licensee, Kim Bailey. LPA observed 8 children in care.

During the visit LPA, inspected the spa cover, there is no water currently in the spa. LPA took a photo of the spa cover. LPA conducted the annual visit interview with the Licensee.

LPA cleared the deficiency on this date and provided a copy of the POC clearance letter during the visit.

At this time, the facility is in compliance with California Code of Regulations Title 22. Therefore, no deficiencies are being cited.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Licensee, Kim Bailey.

SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Carolyn TubaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 05/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/20/2024
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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