Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197417875
Report Date: 06/23/2016
Date Signed 06/23/2016 03:04:37 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:CONSTON FAMILY CHILD CAREFACILITY NUMBER:
197417875
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 5DATE:
06/23/2016
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
02:18 PM
MET WITH:Cynthia ConstonTIME COMPLETED:
03:10 PM
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Licensing Program Analyst (LPA), Silva Garibyan conducted a Plan of Correction visit (POC). On the initial visit of 6/02/2016, the licensee's assistant was alone with three children. Licensee was cited for the following deficiencies:

1) Un-fingerprinted adult working at the facility
2) The Emergency Disaster Plan was not posted in the facility.


The assistant ( cleaning lady) is fingerprint cleared and associated to the facility.
LPA observed the Disaster Plan posted in the kitchen.

During POC visit, LPA reviewed children's files for completeness. Children's files are complete and LIC 9224 signed and placed in the files

All deficiencies have been cleared.

At the time of the Plan Of Correction visit the facility was found to be in substantial compliance.
Exit interview was conducted and copy of report was provided.
SUPERVISOR'S NAME: Mary RuizTELEPHONE: (310) 337-4826
LICENSING EVALUATOR NAME: Silva GaribyanTELEPHONE: (310) 337-3754
LICENSING EVALUATOR SIGNATURE:

DATE: 06/23/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2016
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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