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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400286
Report Date: 10/05/2020
Date Signed: 10/12/2020 08:49:13 AM

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:MOORE FAMILY CHILD CAREFACILITY NUMBER:
198400286
ADMINISTRATOR:CHRYSTAL MOOREFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 362-9727
CITY:LONG BEACHSTATE: CAZIP CODE:
90805
CAPACITY:14CENSUS: 0DATE:
10/05/2020
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Applicant, Chrystal MooreTIME COMPLETED:
10:22 AM
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On October 5, 2020 at 10:00 AM, Licensing Program Manager (LPM) Brandi Van Oosten and Licensing Program Analyst (LPA) Monique Ayala met with Applicant, Chrystal Moore via Zoom Meeting. The meeting was held via Zoom Meeting due to the Coronavirus Disease 2019 (COVID-19) pandemic. The purpose of the meeting was to conduct a follow-up Prelicensing tele-inspection.

At 10:04 AM, the applicant guided LPM Van Oosten and LPA Ayala on a virtual tour of the main home. LPM Van Oosten and LPA Ayala viewed the areas accessible to children: entry way (front door), kitchen, living room (child care area) and restroom. Applicant confirmed and showed the licensing representatives that the main home consists of three (3) bedrooms that are "off-limits" to children.

At 10:08 AM, the applicant guided LPM Van Oosten and LPA on a virtual tour of the detached garage that is converted into a living space. LPM Van Oosten and LPA Ayala viewed areas accessible to children: entry way, kitchen, living room (alternative child care space) and restroom. LPM Van Oosten and LPA Ayala also viewed the "off-limit" areas: bedroom and enclosed patio. The applicant has a child safety gate for the entry way into the bedroom, which leads to the enclosed patio to keep the areas inaccessible to children. Applicant denied that anyone resides in the detached garage.

As a reminder, individuals who are 18 years of age or older and residing in the home, including the detached garage must obtain a criminal record clearance and be associated to the facility. Individuals within one month of their 18th birthday must be fingerprinted immediately. Failure to obtain criminal record background check clearances prior to initial presence in the home will result in an immediate $100.00 dollar or more per day civil penalty.

Applicant was informed that the Department is pending clarification from the Fire Department. An exit interview was conducted with the applicant. A copy of this report was issued to the applicant via mail.
SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Monique AyalaTELEPHONE: (323) 246-2016
LICENSING EVALUATOR SIGNATURE:

DATE: 10/05/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2020
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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