<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197419688
Report Date: 02/15/2024
Date Signed: 02/15/2024 01:24:26 PM

Document Has Been Signed on 02/15/2024 01:24 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:AUSTIN FAMILY CHILD CAREFACILITY NUMBER:
197419688
ADMINISTRATOR:AUSTIN, LATIESHAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 333-4647
CITY:LOS ANGELESSTATE: CAZIP CODE:
90008
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 8DATE:
02/15/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
09:01 AM
MET WITH:Latiesha Austin, LicenseeTIME COMPLETED:
01:30 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 2/15/2024 at 9:01 AM, Licensing Program Analyst (LPA) Elicia Calvillo conducted an unannounced visit. LPA identified self and met with Aiyana Graham, Assistant, who guided analyst on a tour of the inside and outside of the facility. LPA observed 6 Children and 2 staff, at 9:27AM 2 additional children arrived. At 9:47AM, Latiesha Austin, Licensee arrived at the facility.

At 9:01AM, LPA confirmed Aiyana Graham, has worked since 2/14/2024 as an assistant at the facility and did not have an Criminal Record Clearance associated with facility.

Licensee did not request a transfer of a criminal record clearance for those individuals subject to a criminal record review per regulation 102370(d)(2) Criminal Record Clearance.

As a result of today's visit, a Type B Deficiency was issued for regulation102370(d)(2) Criminal Record Clearance and a Plan of Correction is due 2/15/2024. A Civil Penalty of $200.00 will be assessed today due to the staff not having a Criminal Record Clearance associated to the facility.

A notice of site visis was given and must remain posted for 30 days, exit interview conducted and report was reviewed with the licensee Latisha Austin.
SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE: DATE: 02/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/15/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
Document Has Been Signed on 02/15/2024 01:24 PM - It Cannot Be Edited


Created By: Elicia Calvillo On 02/15/2024 at 12:04 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: AUSTIN FAMILY CHILD CARE
FACILITY NUMBER: 197419688

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/15/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/15/2024
Section Cited
CCR
102370(d)(2)

1
2
3
4
5
6
7
102370 Criminal Record Clearance(d)All individuals subject to a criminal record review...shall prior to working, residing, or volunteering in a licensed facility: (2) Request a transfer of a criminal record clearance as specified in Section 102370(j) This requirement is not met as evidenced by:
1
2
3
4
5
6
7
Licensee stated the Plan of Correction (POC) will be complete the LIC 9182 Criminal Record Transfer Request and provided the form to LPA on 2/15/2024.
8
9
10
11
12
13
14
Based on review of Guardian associations Aiyana Graham, hired date 2/14/2024 has a criminal record clearance but is not associated. Licensee admitted she did not request a transfer to associate Aiyana Graham to the facility.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Rita Ramos
LICENSING EVALUATOR NAME:Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:
DATE: 02/15/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/15/2024


LIC809 (FAS) - (06/04)
Page: 2 of 2