197700220-8-8-2023-12-CC-JTAO-CUHQAC-20230808115943

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197700220
Report Date: 08/08/2023
Date Signed: 08/08/2023 11:59:49 AM

Document Has Been Signed on 08/08/2023 11:59 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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME:	DAVIS, TOSHA FAMILY CHILD CARE		FACILITY NUMBER:	197700220
ADMINISTRATOR:	TOSHA DAVIS		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(661) 429-9780
CITY:	QUARTZ HILL	STATE: CA	ZIP CODE:	93536
CAPACITY:	14	CENSUS: 9	DATE:	08/08/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Tosha Davis, Licensee		TIME COMPLETED:	12:10 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 08/08/23 Licensing Program Analyst (LPA) Justeene Tamayo met with Licensee, Tosha Davis, who guided analyst on a tour of the facility for the One Year Required inspection. This is a two story, 4 bedroom, 3 bathroom home with kitchen/dining, family room, living room, laundry room and garage. There is a spa or body of water on the premises. Upon arrival LPA observed 8 preschool children and 1 infant in care, along with assistant #1. Family members residing in the home include 3 adults (licensee, licensee husband, and licensee's daughter) and no minor children. Facility operation are Monday-Friday 7AM-4PM. Incidental Medical Services (IMS) policy was discussed. Physical Plant: Main care is provided in the living room, family room, and dining room. Children use the bathroom in hallway on the left. Off limit areas include all bedrooms, bathrooms #2 and #3 (upstairs), laundry room (barricaded gate), and garage (has a key lock door knob). The home was inspected inside and out for safety, clean and orderly, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds (laundry room and under kitchen sink with safety latch), medicines (upper kitchen cabinet) and hazardous items (sharp knives in upper kitchen pantry unreachable to children in care) that can pose a danger to children. LPA observed the fireplace to be barricaded. Safe and age appropriate toys, play equipment and materials were observed. The smoke detector and carbon monoxide detector, Fire Extinguisher (2A10BC) are in operable condition. Per Licensee no one smokes in the home. Electrical outlets are inaccessible.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Justeene Tamayo	TELEPHONE: 661-202-3796
LICENSING EVALUATOR SIGNATURE:	DATE: 08/08/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2023

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: DAVIS, TOSHA FAMILY CHILD CARE	FACILITY NUMBER: 197700220
	VISIT DATE: 08/08/2023

NARRATIVE

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LPA reminded licensee that no baby bouncers saucer chairs, or any recalled and or prohibited toys or sleep/ play equipment are allowed on the premises. There is a designated area for ill children as necessary on the porch area. Per Licensee, there is one firearm on the premises. LPA observed two safes with a key code. Per licensee, one safe is for the ammunition, and the other safe is for the firearm following Title 22 regulations. The facility sketch is complete and current, there is working telephone (cell).

Last fire/disaster drill is complete and maintained current. Last Fire/Disaster Drill was completed on 03/12/2023.

Roster complete and maintained current.

Bathroom: Shower/tub are free of hazards (child care bathroom). LPA did not observe any hazardous items in the children's bathroom. Toilet and faucet are clean and operable.

Kitchen: Sharp utensils, open bottles or alcohol are inaccessible. If food is brought from the children’s home, the container shall be labeled with the child’s name and properly stored or refrigerated. The home has a clean and fully stocked refrigerator/freezer. Cleaning supplies are in the kitchen (off limit area). Breakfast, lunch, snacks and dinner are provided. Licensee currently has a food program. Naps are provided on mats in the living room, dining area, and family room.

Outdoor: The backyard is safe for children. The backyard is completely fenced (with block cement). There is no body of water. LPA observed age appropriate toys. LPA also observed the barbecue pit and hot tub fully covered making it inaccessible to children in care. Per licensee, there are two pets on the premises.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Justeene Tamayo	TELEPHONE: 661-202-3796
LICENSING EVALUATOR SIGNATURE:	DATE: 08/08/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2023

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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: DAVIS, TOSHA FAMILY CHILD CARE	FACILITY NUMBER: 197700220
	VISIT DATE: 08/08/2023

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Advisory/Other: First Aid kit was observed with supplies readily available. CPR/First Aid expires 07/29/2024. Mandated reporter training expires 08/16/2024. There are no window cords accessible to children.

Documents Provided and or Discussed: Fire Drill Log, Roster, Postings, Safe Sleep PIN 20-24-CCP, Individual Sleeping Plan (LIC 9227), and Safe Sleep Log. Licensee stated currently does not have child care insurance.

Licensee Davis 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 discussed the safe sleep regulations with licensee Davis and discussed the Child Care Licensing Safe Sleep webpage 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.

No deficiencies have been cited at this time.

A notice of site visit was given to licensee and must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the licensee Tosha Davis along with her appeal rights and Notice of Site Visit.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Justeene Tamayo	TELEPHONE: 661-202-3796
LICENSING EVALUATOR SIGNATURE:	DATE: 08/08/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2023

LIC809 (FAS) - (06/04)

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