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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198010536
Report Date: 02/04/2025
Date Signed: 02/04/2025 12:07:07 PM

Document Has Been Signed on 02/04/2025 12:07 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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:TILLMAN FAMILY CHILD CAREFACILITY NUMBER:
198010536
ADMINISTRATOR/
DIRECTOR:		TILLMAN, TRACEYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 209-8686
CITY:LOS ANGELESSTATE: CAZIP CODE:
90061
CAPACITY: 14TOTAL ENROLLED CHILDREN: 9CENSUS: 4DATE:
02/04/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:25 AM
MET WITH:Licensee/ Tracy Tillman TIME VISIT/
INSPECTION COMPLETED:
12:25 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 February 4, 2025 at 10:30 am, Licensing Program Analyst (LPA) Ashley Calderon and Tyler Reyes conducted an unannounced case management inspection and met with licensee, Tracey Tillman. Licensee allowed LPA's entrance to the facility. The purpose of today's inspection was to verify if Licensee lives at the day care and LPA's disclosed purpose of today's visit to the Licensee.

Upon entrance LPA's observed two adults: Licensee and per Licensee visitor is their relative and 3 children at the time of visit. LPA's observed visitor was not interacting with children and shortly after LPA's arrived, visitor left the facility. LPAs consulted with Licensee regarding regulations on visitors and volunteers.

LPAs toured the facility indoor and outdoor with permission of Licensee T.Tillman. LPAs alongside with T.Tillman observed off limit Licensee's bedroom and office space.

Licensee provided their Driver's Licensee and two forms of Mailing letters. LPA took pictures of items, address on items matched the facility address. Per Licensee stated lives in the back area of the home.

LPA's consulted with Licensee regarding outdoor area, LPAs observed a wire on the floor by the gate leading to the back yard, an air pump machine in the back yard, and leaf blower with extension cord by the side of the house that leads to the backyard. Licensee stated will clean up and put items away before children play in the afternoon. Per Licensee, child have not played outside as of yet. LPA's observed no children in the out door yards.

During this time no citations were provided. Exit interview conducted and report was reviewed with Licensee, Tracey Tillman. A notice of site visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Ashley Calderon
LICENSING EVALUATOR SIGNATURE: DATE: 02/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/04/2025
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 1