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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198013548
Report Date: 12/17/2021
Date Signed: 12/17/2021 01:53:10 PM

Document Has Been Signed on 12/17/2021 01:53 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:ADAMS & MCCRAW FAMILY CHILD CAREFACILITY NUMBER:
198013548
ADMINISTRATOR:ADAMS, RAYJENNIA&MCCRAW, MFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 564-0901
CITY:LOS ANGELESSTATE: CAZIP CODE:
90059
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 2DATE:
12/17/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Reyjennia McCraw, LicenseeTIME COMPLETED:
02:12 PM
NARRATIVE
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Licensing Program Analyst (LPA) Susann Sanchez conducted an unannounced case management visit for the purpose of confirming the removal of employee Shawn McCraw. Upon arrival, LPA met with Licensee Reyjennia Adams, who gave LPA a tour of the facility, including “off limit” areas. Licensee reported to the department she was in receipt of letter from Caregiver Background Check Bureau dated November 22, 2021 indicating her employee may not work or be present in the facility due to an invalid criminal record clearance.

LPA confirmed employee, Shawn McCraw was not present at the facility and is no longer working. LPA confirmed that Licensee has dissociated the employee from her facility license. Licensee submitted a written declaration to the department stating the employee who is also her son, moved out of the home and is no longer living there since November 1, 2021. Licensee returned copy of confirmation of removal to the department timely. LPA obtained a signed copy of Confirmation of Removal for Shawn McCraw during today’s visit. Verification of Removal is complete.

Also discussed with the Licensee was the arrest of her employee Shawn McCraw that occurred on 05/20/2020 and was not reported to the department. The facility failed to report that assistant was arrested and convicted of a felony incident to the Department within the required 24 hours. LPA conducted interviews with Licensee and children in care. LPA confirmed Licensee’s hours of operation. Licensee completed an updated LIC279.


California Code of Regulations, Title 22, Division 12, are being cited on the attached LIC 809D.

Exit interview was conducted with Licensee Reyjennia Adams. A copy of the appeal rights (LIC9058 01/16) were provided and explained. Upon receipt, Licensee posted the Notice of Site Visit. The Notice of Site Visit shall be posted for thirty (30) consecutive days. Failure to maintain posting as required will result in a $100.00 civil penalty.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Susann Sanchez
LICENSING EVALUATOR SIGNATURE: DATE: 12/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/17/2021
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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Document Has Been Signed on 12/17/2021 01:53 PM - It Cannot Be Edited


Created By: Susann Sanchez On 12/17/2021 at 01:13 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
, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: ADAMS & MCCRAW FAMILY CHILD CARE
FACILITY NUMBER: 198013548

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/17/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/31/2021
Section Cited
CCR
102416.2(a)

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102416.2(a) Reporting Requirements (a)The licensee shall report the following information the Department by telephone or fax within the Department's next business day and during normal working hours (8am to 5pm). The requirement was not met as evidenced by: based on interviews conducted with Licensee, licensee admitted to not reporting
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Per Licensee incident did not occur in her FCCH or near any children. Licensee states that in the future she will report all incident involing her FCCH within the 24 hours. Licensee submitted a declaration stating to report any incidents.
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 the employee’s arrest to CCLD which poses a potential safety risk to children in care.
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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:Valarie Cook
LICENSING EVALUATOR NAME:Susann Sanchez
LICENSING EVALUATOR SIGNATURE:
DATE: 12/17/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/17/2021


LIC809 (FAS) - (06/04)
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