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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019364
Report Date: 03/23/2023
Date Signed: 03/23/2023 01:08:19 PM


Document Has Been Signed on 03/23/2023 01:08 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:GRAHAM FAMILY CHILD CAREFACILITY NUMBER:
198019364
ADMINISTRATOR:FALLON TIANA GRAHAMFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 500-5600
CITY:DIAMOND BARSTATE: CAZIP CODE:
91765
CAPACITY:14CENSUS: 9DATE:
03/23/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Gail Graham & Jiovondra Cullins & Fallon GrahamTIME COMPLETED:
01:10 PM
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Case management inspection conducted by Licensing Program Analysts (LPA) Jennifer Hua and Veronica Martinez-Garza. The purpose of this inspection is to follow up on the deficiencies cited on 3/16/2023. LPAs allowed entry by assistant Jiovondra Cullins. Purpose of the visit was announced. Assistant Cullins stated that licensee is out picking up children. LPAs toured the facility and observed 9 children in care (2 infants & 7 preschool-age) supervised by assistants Jiovondra Cullins and licensee's mother/assistant Gail Graham. Licensee arrived at 1:00.

During the visit, LPAs observed the following:

Facility within Staffing Ratio and Capacity
No infant napping in car seat or on sofa.

Based on observations today, deficiencies are corrected.

An exit interview conducted with licensee. Notice of Site visit form was provided and shall be posted for 30 days in an area accessible for review.
SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Jennifer HuaTELEPHONE: (323) 981-3375
LICENSING EVALUATOR SIGNATURE:
DATE: 03/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/23/2023
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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