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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 336300181
Report Date: 12/07/2021
Date Signed: 12/08/2021 11:03:27 AM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 12/08/2021 11:03 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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:WILLIAMS FAMILY CHILD CAREFACILITY NUMBER:
336300181
ADMINISTRATOR:WILLIAMS,TANYAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(951) 591-7330
CITY:PERRISSTATE: CAZIP CODE:
92571
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: DATE:
12/07/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:28 PM
MET WITH:AttemptedTIME COMPLETED:
12:35 PM
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Licensing Program Analyst (LPA) Sumayya Habeebulla arrived at the facility to conduct a required annual inspection on 12/07/21 at the time listed. LPA rang the doorbell a couple of times. A male adult answered the door and LPA identified herself, handed over a business card, and stated the reason for the visit. The Male adult stated he was Frank Williams and the Licensee was not home. LPA inquired when the Licensee will be back, and he stated probably tomorrow. LPA asked if there are any children currently in care and he stated 'no'. LPA asked if there will be children in care tomorrow and he said yes. As per LPA's observation there were no children in the house. LPA requested Mr. Williams to request Licensee to call LPA back as soon as possible.
LPA tried calling Licensee on the phone number provided to the Department and left a detailed message stating that LPA is at the door for an annual inspection and a male adult had answered the door and he was not associated to the facility which would result in a Civil Penalty. LPA requested a call back as soon as she receives the message.
LPA received a call back at 1:04 PM from Licensee stating that she was at the store and she never had any children enrolled at the center from the time she was licensed, and it is very hard trying to find children for her daycare. LPA asked who the male adult was, and she stated her brother. LPA told Licensee that he is not associated to the facility and she stated that he is home for the holidays and since she doesn’t have any children enrolled in care she did not think of clearing and associating him. LPA also stated to Licensee that he had stated she will only be back tomorrow, and she responded he had not met her yet and therefore he does not know about where she was. Licensee wanted to know the options available for her since she does not have any children in care and needs to look for a job. LPA explained the option of Inactive status and Licensee opted to place her facility on Inactive status. LPA will be emailing Licensee the form for inactive status as soon as she is back in the office.
LPA stressed that the form needs to be completed and mailed to the Department for the facility to go inactive.
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Sumayya Habeebulla
LICENSING EVALUATOR SIGNATURE: DATE: 12/08/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/08/2021
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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