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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197416022
Report Date: 04/12/2023
Date Signed: 04/13/2023 08:02:50 AM


Document Has Been Signed on 04/13/2023 08:02 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
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245



FACILITY NAME:TOMLINSON FAMILY CHILD CAREFACILITY NUMBER:
197416022
ADMINISTRATOR:TOMLINSON, ALEXFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 984-0308
CITY:LOS ANGELESSTATE: CAZIP CODE:
90066
CAPACITY:14CENSUS: 7DATE:
04/12/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:ALEX TOMLINSON, LICENSEETIME COMPLETED:
01:30 PM
NARRATIVE
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On 04/12/2023 Licensing Program Analyst (LPA), Lisa Clayton, arrived at the home un-announced, to conduct an Annual Inspection and was met by Licensee Alex Tomlinson. LPA Clayton observed 7 children in care. Operating hours are Monday – Friday, 8am – 4:30pm. Licensee provides lunch, and am/pm snacks.

Upon arrival LPA Clayton counted 6 children in care. While touring the home for a Health and Safety inspection, LPA Clayton observed an infant in licensee’s bedroom, crying behind a closed door.

LPA Clayton toured the inside and outside of the home for a Health and Safety inspection. The home consist of the following: 2 bedrooms, 1 bathroom, living room, kitchen/dining area, family room, converted attached garage, and fenced front back yard.

The ON LIMIT areas are as follows: kitchen, the living room (napping area), family room (day care area), fenced backyard and bathroom.

The OFF-LIMIT areas are: bedrooms 1 and 2, and the converted attached garage, all of which are to be made inaccessible by locked doors, child safety gates, and supervision.

The home has a working smoke detector in the kitchen. The home has adequate heating and ventilation for safety and comfort. LPA Clayton observed toys and play equipment that are safe. The home has working telephone service and LPA confirmed the phone number is (310) 927-3433.

The Per the licensee, there are no firearms in the home. There are no swimming pools, ponds, or other bodies of water on the property. Any detergents, cleaning compounds, medication, poisons, and other hazardous items are made inaccessible to children.

Licensee ensures that children in care are supervised at all times and is aware children shall not be left in parked vehicles. Car seats are used for transportation purposes only and are not used for sleeping children.

Licensees’ pediatric CPR/First Aid certificate expires 10/2024. LPA Clayton emailed licensee the link to complete the required Mandated Reporter Training. Licensee will provide LPA Clayton with a copy of the certificate on Monday 04/17/2023. A review of facility records indicates that the Licensee is in compliance with the immunization laws pertaining to childcare providers.

SUPERVISOR'S NAME: Karren StarksTELEPHONE: (310) 740-3038
LICENSING EVALUATOR NAME: Lisa ClaytonTELEPHONE: (424) 301-3206
LICENSING EVALUATOR SIGNATURE:
DATE: 04/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/12/2023
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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Document Has Been Signed on 04/13/2023 08:02 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245


FACILITY NAME: TOMLINSON FAMILY CHILD CARE
FACILITY NUMBER: 197416022

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/12/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102425(j)(4)
Infant Safe Sleep
The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall be near enough to the sleeping infant to be able to hear them wake up.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in [count] out of [total count] [(objects) (persons)] [identifiers] which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 04/12/2023
Plan of Correction
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Licensee will ensure that children are supervised at all times, including nap times and children are not to be sleeping in the off limit areas. In addition, any rooms where children are sleeping, the doors are to remain open. Licensee will watch the Supervising Children in Family Child Care video on the Community Care Licensing website.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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.
SUPERVISOR'S NAME: Karren StarksTELEPHONE: (310) 740-3038
LICENSING EVALUATOR NAME: Lisa ClaytonTELEPHONE: (424) 301-3206
LICENSING EVALUATOR SIGNATURE:
DATE: 04/12/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/12/2023
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 04/13/2023 08:02 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245


FACILITY NAME: TOMLINSON FAMILY CHILD CARE
FACILITY NUMBER: 197416022

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/12/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.543
Licensure Requirements
Every family day care home for children shall have one or more carbon monoxide detectors in the facility that meet the standards established in Chapter 8 (commencing with Section 13260) of Part 2 Division 12. The department shall account for the presence of these detectors during inspections.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in [count] out of [total count] [(objects) (persons)] [identifiers] which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/13/2023
Plan of Correction
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Licensee will have a Carbon Monoxide detector in the home no later than the above mentioned POC date.
Type B
Section Cited
CCR
102417(b)
Operation of A Family Child Care Home
(b) The home shall be kept clean and orderly, with heating and ventilation for safety and comfort.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in [count] out of [total count] [(objects) (persons)] [identifiers] which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/17/2023
Plan of Correction
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Licensee will ensure that the home is kept clean and orderly no later than the above mentioned POC date not limited to but including the on limit bathroom, kitchen and refridgerator where the childrens food is stored and prepared.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Karren StarksTELEPHONE: (310) 740-3038
LICENSING EVALUATOR NAME: Lisa ClaytonTELEPHONE: (424) 301-3206
LICENSING EVALUATOR SIGNATURE:
DATE: 04/12/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/12/2023
LIC809 (FAS) - (06/04)
Page: 3 of 15


Document Has Been Signed on 04/13/2023 08:02 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245


FACILITY NAME: TOMLINSON FAMILY CHILD CARE
FACILITY NUMBER: 197416022

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/12/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(c)
Infant Safe Sleep
An Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be completed for each infant up to 12 months of age the provider has in care and included in the infant's file at the facility.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in [count] out of [total count] [(objects) (persons)] [identifiers] which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/14/2023
Plan of Correction
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Licensee will have the Individual Sleeping Plan completed by the parents as needed and place a copy in the child's file.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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.
SUPERVISOR'S NAME: Karren StarksTELEPHONE: (310) 740-3038
LICENSING EVALUATOR NAME: Lisa ClaytonTELEPHONE: (424) 301-3206
LICENSING EVALUATOR SIGNATURE:
DATE: 04/12/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/12/2023
LIC809 (FAS) - (06/04)
Page: 4 of 15


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: TOMLINSON FAMILY CHILD CARE
FACILITY NUMBER: 197416022
VISIT DATE: 04/12/2023
NARRATIVE
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LPA Clayton instructed licensee to get a new 2A10BC Fire Extinguisher, as her current one is expired.

Incidental Medical Services (IMS) are not being provided at this time. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. LPA Clayton provided licensee with an IMS Plan sample. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

For licensing updates email childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of 100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA Clayton provided licensee with a copy of the the safe sleep regulations with and discussed the Child Care Licensing Safe Sleep web page at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

SUPERVISOR'S NAME: Karren StarksTELEPHONE: (310) 740-3038
LICENSING EVALUATOR NAME: Lisa ClaytonTELEPHONE: (424) 301-3206
LICENSING EVALUATOR SIGNATURE:

DATE: 04/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/12/2023
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: TOMLINSON FAMILY CHILD CARE
FACILITY NUMBER: 197416022
VISIT DATE: 04/12/2023
NARRATIVE
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Deficiencies and Technical Advisories were cited today, Per Title 22, Division 12, Chapter 3, of the California Code of Regulations (see LIC 809D) and TA notes.

LPA Clayton reviewed the Deficiencies and Technical Advisories with licensee. Licensee acknowledged understanding. LPA Clayton provided licensee with the LIC 311 (Forms/Records to be kept in Your Family / Child Care Home), and discussed the documents required.

Copied of the deficiency pages as well as the LIC 9224 are to be provided to the parents of the currently enrolled children, as well as newly enrolled children for the next 12 months.

An exit interview was conducted, a copy of this report was read and provided to the Licensee Alex Tomlinson. This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit was provided and required to be posted for 30 days.

SUPERVISOR'S NAME: Karren StarksTELEPHONE: (310) 740-3038
LICENSING EVALUATOR NAME: Lisa ClaytonTELEPHONE: (424) 301-3206
LICENSING EVALUATOR SIGNATURE:

DATE: 04/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/12/2023
LIC809 (FAS) - (06/04)
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