198020227-1-8-2020-54-CC-JCHZ-BKMRPZ-20200108121246

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198020227
Report Date: 01/08/2020
Date Signed: 01/08/2020 12:12:52 PM

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:	TOLIVER FAMILYCHILD CARE		FACILITY NUMBER:	198020227
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 0	DATE:	01/08/2020
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Erinn Toliver, Applicant		TIME COMPLETED:	12:30 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	PRELICENSING INSPECTION CONDUCTED IN ENGLISH Licensing Program Analyst (LPA) Janeth Chavez conducted an announced pre-licensing inspection today. LPA met with Erinn Toliver who guided LPA on a tour of the facility indoors and outdoors. Family members residing in the home are 2 adults and 1 infant child. Applicant has applied for a small family child care home license. Present during today's inspection is applicant and Gilbert Givens. The reason for today's inspection is to measure the fence around the pool area. LPA observed mesh fencing completely surrounding the pool area in the backyard. The fence measures 5 feet high and is non-climbable. It has a self-closing gate that swings away from the pool and is self-latching. Please note that the backyard is an off-limit area for daycare children. Applicant stated that only the front yard (not fenced) will be used for outside play. The applicant was advised to have 100% supervision when daycare children are playing in the front yard. There are two windows in the living room area and the applicant has placed extra white plastic window latches on the windows. There are two latches on each window to prevent daycare children from being able to open the windows. As per applicant the windows will not be open as there is central air in the home. The applicant has placed an extra chain lock on the garage door that leads to the backyard. The garage door has a plastic door knob safety cover, a turn knob, and the extra chain lock up high so that children cannot open it. There are double glass doors and double metal gate doors in the applicant's bedroom that lead to the backyard. However, applicant stated that the double metal gate doors will be kept locked. The double glass doors have a lock and an alarm has been placed on the double glass doors for extra safety. Also, the applicant's bedroom is an off-limit area and will be kept locked during daycare hours. Applicant has placed a plastic door knob safety cover to prevent daycare children from opening the door. Please note this is an off-limit area. Report Continues on Next Page

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Janeth Chavez	TELEPHONE: (323) 981-3376
LICENSING EVALUATOR SIGNATURE:	DATE: 01/08/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2020

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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: TOLIVER FAMILYCHILD CARE	FACILITY NUMBER: 198020227
	VISIT DATE: 01/08/2020

NARRATIVE

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The applicant has placed an extra chain lock up high on the kitchen door.

The applicant corrected the following:

The applicant barricaded the fireplace by placing a chain lock to prevent children from accessing it. Also, there is a sectional barricading the fireplace, as per applicant the fireplace is non-operational.

The applicant has a plastic gate at the top of the stairs to prevent children from accessing the second floor.

There are no pending corrections at this time.

A final review of the application will be conducted by the Department. Once licensed, the applicant is required to adhere to the terms and limitations stated on the license.

Exit interview was conducted with Erinn Toliver, applicant, who is in agreement with the above. A copy of this report and all other Licensing reports must be made available to the public for 3 years.

End of Report

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Janeth Chavez	TELEPHONE: (323) 981-3376
LICENSING EVALUATOR SIGNATURE:	DATE: 01/08/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2020

LIC809 (FAS) - (06/04)

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