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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020206
Report Date: 06/07/2022
Date Signed: 06/07/2022 08:51:04 AM


Document Has Been Signed on 06/07/2022 08:51 AM - 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:MOSER FAMILY CHILD CAREFACILITY NUMBER:
198020206
ADMINISTRATOR:ALEXIS T. MOSERFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 632-8464
CITY:WHITTIERSTATE: CAZIP CODE:
90606
CAPACITY:14CENSUS: 1DATE:
06/07/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Alexis Moser, LicenseeTIME COMPLETED:
09:00 AM
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Licensing Program Analyst (LPA) Lilli Babcock conducted an unannounced POC (plan of correction) inspection to insured that the Type B deficiency cited on 5/20/22 has been cleared. LPA met with Alexis Moser, licensee who guided analyst on a tour of the facility. There was 1 child present during this inspection. The following was observed:

- LPA observed the Fire Extinguisher in the facility to have a service tag dated 5/8/22. Licensee stated she was not home when the fire extinguisher servicing company came to her facility, so they left her an already serviced fire extinguisher at her home with a service tag date of 5/8/22.

LPA advised the licensee how to access forms, regulations and quarterly updates on the Child Care Licensing Website at: www.ccld.ca.gov.

LPA cleared deficiency on this date and provided a copy of the Licensing Report to Alexis Moser, licensee. LPA issued POC clearance letter during the visit.

At this time, the licensee 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. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.



Exit interview conducted and report was reviewed with Licensee, Alexis Moser.

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SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Lilli BabcockTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 06/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/07/2022
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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