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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197400162
Report Date: 08/31/2023
Date Signed: 08/31/2023 02:35:09 PM

Document Has Been Signed on 08/31/2023 02:35 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:JACKSON FAMILY DAY CAREFACILITY NUMBER:
197400162
ADMINISTRATOR:BRENDA JEAN JACKSONFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 735-6991
CITY:LOS ANGELESSTATE: CAZIP CODE:
90016
CAPACITY: 12TOTAL ENROLLED CHILDREN: 12CENSUS: 0DATE:
08/31/2023
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Brenda Jackson, LicenseeTIME COMPLETED:
02:55 PM
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Licensing Program Analyst (LPA) Susann Sanchez, conducted an unannounced annual required inspection at the above facility on 08/31/2023 at 1:45 PM. LPA met with Brenda Jackson, Licensee. At time of visit there were 0 children present. Upon arrival, Licensee informed LPA that she was closed until Tuesday 09/05/23, due to the holiday and that Licensee has to do a personal appointment at 3:00pm 08/31/23. LPA explained that LPA can return at a different time. Per Licensee stated that we can start the inspection. Licensee gave LPA a tour of the facility at 2:00pm. Per Licensee current hours of operation Monday to Friday 5:30am to 8:00am and again at 2:30pm to 6:00pm. Per Licensee, is available 24/7 if needed.

The home is a single story 3 bedroom, 3 bathroom dwelling with a detached back house. Licensee stated presently using the living room for activities, bathroom and front yard. All other areas are "off limit." A Licensee has a laundry room adjacent to the back house that remains closed and inaccessible to the children. Licensee states there are no firearms or weapons in the home and no bodies of water.

Smoke detectors and carbon monoxide detector were tested and operable. Furniture and equipment was inspected for age appropriateness and good repair. Telephone service, lighting and ventilation were evaluated and found to meet standards.

Due to time constraints, LPA will return at a later date to complete annual inspection.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Licensee, B. Jackson
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Susann Sanchez
LICENSING EVALUATOR SIGNATURE: DATE: 08/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/31/2023
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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