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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 192000542
Report Date: 11/21/2023
Date Signed: 11/21/2023 02:46:16 PM

Document Has Been Signed on 11/21/2023 02:46 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 S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:CLAXTON FAMILY CHILD CAREFACILITY NUMBER:
192000542
ADMINISTRATOR:SANDRA E. CLAXTONFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 638-3580
CITY:COMPTONSTATE: CAZIP CODE:
90220
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 3DATE:
11/21/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Licensee, Sandra ClaxtonTIME COMPLETED:
03:05 PM
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On November 21, 2023, at 1:45 PM, Licensing Program Analysts (LPAs) Angelica Wallin and Susann Sanchez, conducted an unannounced Annual Required Inspection for the above facility license. During today’s inspection, LPA met with licensee, Sandra Claxton. There were 3 children present when LPA arrived.
Licensee stated she has not had any children since the pandemic. Licensee stated she only cares for her grandchildren at this time. LPAs explained to licensee that they have an option of inactive status while due to medical reason. Licensee stated that they would like to place their license in inactive status from 11/21/23 to 11/21/24. LPA provided and obtained the LIC 9211 from the licensee during inspection.

Licensee agrees to the following:
I. Will not provide child care for which a license is required until license is reactivated.
II. Will continue to promptly pay the annual license fee.
III. Will inform Licensing office of any changes in the above dates prior to re-opening facility by submitting a new LIC 9211
IV. Licensee will be in compliance with all licensing laws and regulations upon re-opening facility, including but not limited to:
· Ensuring all adult staff and residents, including children who turn 18 during the inactive period, have criminal record clearances
· Maintaining current CPR and First Aid certifications
· Maintaining a current fire extinguisher and functioning smoke alarms

During inspection LPAs reviewed personnel roster and gave Licensee LIC 126 (entrance checklist). Due to licensee request to become inactive, visit became an unannounced Case Management Inspection.

Exit interview conducted and report was reviewed with licensee, Sandra Claxton. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Angelica Wallin
LICENSING EVALUATOR SIGNATURE: DATE: 11/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/21/2023
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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