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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019864
Report Date: 07/09/2026
Date Signed: 07/09/2026 02:45:30 PM

Document Has Been Signed on 07/09/2026 02:45 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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:WILLIAMS-GREER FAMILY CHILD CAREFACILITY NUMBER:
198019864
ADMINISTRATOR/
DIRECTOR:		KOLISHA WILLIAMSFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 978-5176
CITY:CARSONSTATE: CAZIP CODE:
90746
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
07/09/2026
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:26 PM
MET WITH:Facility Representative Aaron Ephriam TIME VISIT/
INSPECTION COMPLETED:
02:55 PM
NARRATIVE
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Licensing Program Analyst (LPA) Ashley Calderon conducted a case management- other visit for the purpose of previous visit today, LPA observed information that warranted opening this visit. The purpose of this visit was discussed with Facility Representative Aaron Ephriam (Staff #1 -S1).

LPA Calderon observed Child #1 (C1) who is an infant sleeping in a crib from 9:40am - 10:50am with a pacifier that had an attachment on C1's clothing, C1 was not using / sucking on the pacifier, it was observed by C1's mouth, photo taken. In addition, volunteer and staff #2 were in the same area to the sleeping infant. LPA Calderon reviewed Infant Safe Sleep Regulation - 102425 and after regulation was reviewed Staff #2 (S2) removed pacifier attachment from the infant C1, deficiency cited.

Infant Safe Sleep Regulation - 102425 states:

    (1) Pacifiers shall be allowed in the crib or play yard if the following provisions are in place:
    (A) There shall not be anything attached to the pacifier.
    (B)The pacifier shall be specific to the infant it is being given to.

During today's visit LPA Calderon reviewed C1's file. Due to child's age range LPA at 12:57pm requested LIC9227 Individual Infant Sleeping Plan form from (S2), S2 confirmed per interview with LPA Calderon Child #1 does not have a copy of the LIC9227 in their file, LPA observed a blank LIC9227 that was printed out and S2 placed form in C1's personal belonging cubby and informed LPA Calderon will have parent fill out and sign form.
NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Ashley Calderon
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 07/09/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/09/2026
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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Document Has Been Signed on 07/09/2026 02:45 PM - It Cannot Be Edited


Created By: Ashley Calderon On 07/09/2026 at 01:20 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: WILLIAMS-GREER FAMILY CHILD CARE
FACILITY NUMBER: 198019864

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/09/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/10/2026
Section Cited
CCR
102425

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(A) There shall not be anything attached to the pacifier.

The requirement was not meet as evidenced by:
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During today's visit Staff #2 removed pacifier attachment from the infant-C1 clothing.

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LPA Calderon observed Child #1 (C1) who is an infant sleeping in a crib from 9:40am - 10:50am with a pacifier that had an attachment on C1's clothing, C1 not using pacifier, photo taken. After regulation was reviewed, Staff #2 (S2) removed pacifier attachment from the infant-C1.
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Type B
07/17/2026
Section Cited
CCR102425(d)

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(d) The provider shall place infants up to 12 month of age on their backs for sleeping.
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Staff #2 printed out LIC9227 Individual Infant Sleeping Plan and placed in C1 cubby for parent to fill out and sign.

LPA Calderon requested a copy of LIC9227 once completed by C1's parent.
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The requirement was not meet as evidenced by: Per LPA Calderon's observation C1 was sleeping on their left side & not on their back, photo taken & per record review conducted by LPA Calderon, LIC9227 not in C1's file & no authorized signature of parent or staff indicating child can roll on their own.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Warren Birks
NAME OF LICENSING PROGRAM MANAGER:
Ashley Calderon
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 07/09/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/09/2026


LIC809 (FAS) - (06/04)
Page: 3 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: WILLIAMS-GREER FAMILY CHILD CARE
FACILITY NUMBER: 198019864
VISIT DATE: 07/09/2026
NARRATIVE
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Per record review, of no authorized signature of parent or Licensee indicating child can roll on their own and per LPA Calderon's observation C1 was sleeping on their left side and not on their back, photo taken, deficiency cited.

LPA informed staff present infants up to 12 month of age on their backs for sleeping unless they have LIC9227 signatures for observation/ authorization per Infant Safe Sleep Regulation - 102425.

During today's visit 2 deficiencies were cited, and 1 civil penalty was given for a repeated violation on Infant Safe Sleep Regulation - 102425 within 12 months.

A notice of site visit was given to be posted for 30 days and an exit interview was conducted with Licensee Kolisha William-Greer.
NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Ashley Calderon
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/09/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2026
LIC809 (FAS) - (06/04)
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