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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019364
Report Date: 07/06/2023
Date Signed: 07/06/2023 10:47:12 AM

Document Has Been Signed on 07/06/2023 10:47 AM - 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:GRAHAM FAMILY CHILD CAREFACILITY NUMBER:
198019364
ADMINISTRATOR:FALLON TIANA GRAHAMFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 500-5600
CITY:DIAMOND BARSTATE: CAZIP CODE:
91765
CAPACITY: 14TOTAL ENROLLED CHILDREN: 17CENSUS: 7DATE:
07/06/2023
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME BEGAN:
10:01 AM
MET WITH:J. Cullins, J. Brown & F. GrahamTIME COMPLETED:
10:50 AM
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Case management inspection conducted by Licensing Program Analysts (LPA) Jennifer Hua and Veronica Martinez-Garza. The purpose of the quarterly visit is due to the Non-Compliance that was held on 3/24/2023. Upon arrival, LPAs met with assistants Jiovondra Cullins and Jordan Brown. The purpose of the visit was announced. Per assistant Cullins, licensee went to put in prescription. At 10:04am, LPAs toured the facility and observed 7 children in care, 3 of whom are infants. Children were supervised by 2 assistants. At around 10:07am, licensee arrived and stated she was at CVS to check on a prescription..

During the visit, the following were observed and reviewed: Children were in the day care room and living room, no napping children/infant. LPAs observed 2 play yards, one in the living room and one in the day care room, staff and children files reviewed, roster reviewed, drill log observed. Fire drill was conducted on 5/1/23 and earthquake drill was conducted on 6/12/23, personal rights of children and staffing ratio and capacity were met.

Based on review and observation, no deficiency cited during this visit.

An exit interview conducted with licensee, Fallon Graham. Notice of Site Visit form was provided and must be posted for 30 days or a civil penalty of $100 shall be assessed.
SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Jennifer Hua
LICENSING EVALUATOR SIGNATURE: DATE: 07/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/06/2023
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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