Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197417694
Report Date: 08/31/2017
Date Signed 08/31/2017 04:43:18 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6167 BRISTOL PARKWAY #400
CULVER CITY, CA 90230
FACILITY NAME:HAMPTON FAMILY CHILD CAREFACILITY NUMBER:
197417694
ADMINISTRATOR:HAMPTON, DEANNAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 295-5219
CITY:LOS ANGELESSTATE: CAZIP CODE:
90018
CAPACITY:14CENSUS: 3DATE:
08/31/2017
TYPE OF VISIT:Case Management - OtherANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Deanna HamptonTIME COMPLETED:
04:50 PM
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Licensing Program Analyst (LPA) Karren Starks made an unannounced visit for the purpose of conducting a Case Management inspection. LPA met with the licensee, Deanna Hampton. The inspection was to verify that Weslie Durham has been removed from the facility.

Licensee had 3 children in care, 2 of which are guardianship. Also present at the time of visit was the licensee's mother, Reanna Tilford.

The area of the home where Weslie Durham resided was inspected and none of the items observed belonged to Ms. Durham.

No deficiencies cited.

Copy of Report and Notice of Site Visit issued.
SUPERVISOR'S NAME: Jennie FerreiraTELEPHONE: (310) 337-4332
LICENSING EVALUATOR NAME: Karren StarksTELEPHONE: (310) 337-3753
LICENSING EVALUATOR SIGNATURE:

DATE: 08/31/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2017
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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