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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400169
Report Date: 01/26/2023
Date Signed: 01/26/2023 02:32:50 PM

Document Has Been Signed on 01/26/2023 02:32 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:HILES FAMILY CHILD CAREFACILITY NUMBER:
198400169
ADMINISTRATOR:CHELSEA A. HILESFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(714) 655-1233
CITY:LONG BEACHSTATE: CAZIP CODE:
90807
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 7DATE:
01/26/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Chelsea Hiles-Topps, LicenseeTIME COMPLETED:
02:50 PM
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This Case Management- Incident was conducted by Licensing Program Analyst (LPA) Susann Sanchez at the above facility on January 26, 2023 at 12:15PM. LPA met with Licensee Chelsea Hiles-Topps who guided analyst on a tour of the facility. There were 7 children present when LPA arrived. Also present was Licensee assistant, Licensee husband, and Licensee's mother in law. Facility capacity is in compliance for a Large Family Child Care Home. Hours of operation are Mon- Fri 8:00 AM - 5:00PM.

On 01/25/2023, Licensee reported an incident to the department that occurred the same day but not at the facility. During inspection, LPA conducted interview with Licensee and obtain child #1 file. A follow up visit will may be conducted at a later date if needed.

Note: The Licensee stated she will submit written incident report by due date of 02/01/2023.

Exit interview conducted with the Chelsea Hiles-Topps. The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Susann Sanchez
LICENSING EVALUATOR SIGNATURE: DATE: 01/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/26/2023
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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