<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191890457
Report Date: 09/01/2026
Date Signed: 09/01/2026 02:04:20 PM

Document Has Been Signed on 09/01/2026 02:04 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:TOLUCA LAKE EARLY EDUCATION CENTERFACILITY NUMBER:
191890457
ADMINISTRATOR/
DIRECTOR:		LILIA VASQUEZ HERNANDEZFACILITY TYPE:
850
ADDRESS:4915 STROHM AVETELEPHONE:
(818) 980-0925
CITY:NORTH HOLLYWOODSTATE: CAZIP CODE:
91601
CAPACITY: 119TOTAL ENROLLED CHILDREN: 91CENSUS: 80DATE:
09/01/2026
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:18 PM
MET WITH:Lilia Vasquez HernandezTIME VISIT/
INSPECTION COMPLETED:
02:20 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 09/01/2026 at 12:18 p.m., Licensing Program Analyst (LPA) DeCondia Ferguson conducted an unannounced subsequent Case Management-Incident inspection at the above facility for the purpose of concluding the investigation regarding an Unusual Incident Report (UIR) received by the Department concerning an incident that occurred on 07/24/2026.

Upon arrival, LPA met with Principal Lilia Vazquez Hernandez, to whom the purpose of the inspection was announced. The Principal guided LPA on a tour of the facility to obtain a census and provided LPA with a copy of the Staff Roster and Children’s Roster.

In Room #1A, LPA observed 15 children with 3 staff; Room #1B, 12 children with 2 staff; Room #2A, 11 children with 3 staff; Room #3A, 21 children with 4 staff; and Room #3B, 21 children with 3 staff.

The UIR reported that on 07/24/2026, Child #1 (C1) sustained an injury to the eye while outdoors on the climbing structure when a headband worn by Child #2 (C2) made contact with C1's eye.

During the initial inspection conducted on 08/20/2026, LPA toured the facility, conducted interviews with C1, C2, and Staff #1 (S1), and obtained the Staff Roster and Children's Roster (LIC 9040). Additional information was needed to complete the investigation.

During the course of the investigation, LPA conducted interviews with C1, C2, S1, and Parent #1 (P1), and reviewed information regarding the incident and C1's medical treatment.

Raul Navarro
Decondia Ferguson
DATE: 09/01/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/01/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
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)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: TOLUCA LAKE EARLY EDUCATION CENTER
FACILITY NUMBER: 191890457
VISIT DATE: 09/01/2026
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
26
27
28
29
30
31
32
Interviews revealed that C1 and C2 were using the climbing structure when the point of a headband worn by C2 made contact with C1's eye. C1 reported that she was climbing when the headband made contact with her eye. S1 stated that S1 did not witness the actual contact but heard C1 crying and responded to C1. S1 observed redness to C1's eye and provided first aid by washing C1's eye and face and providing an ice pack. S1 further reported that C2 subsequently stated that the headband made contact with C1's eye and that it was an accident.

P1 reported being notified of the incident and taking C1 for medical evaluation. According to P1, C1 sustained a small scratch to the eye and was prescribed eye drops to prevent infection. C1 was restricted from swimming and water play for one week and did not require additional medical follow-up. P1 reported that C1's injury has fully resolved.

Information obtained during the investigation revealed that staff responded after hearing C1 cry, assessed C1's injury, provided first aid, notified C1's parent, and C1 was picked up and taken for medical evaluation. S1 reported that prior to this incident, staff had not identified similar headbands or accessories as a safety concern and there had been no previous incidents involving headbands or similar accessories. Following the incident, the facility notified parents not to send children to school wearing headbands with pointy, sharp, or hard decorations.

Based on interviews conducted, information obtained, and documentation reviewed, the investigation determined that C1 and C2 were using the climbing structure when C2's headband made contact with C1's eye. The information obtained did not establish that the injury resulted from a lack of care and supervision or a violation of Title 22 regulations.

No deficiencies are being cited regarding this incident. The incident is considered closed.

An exit interview was conducted, and the report was reviewed with Principal Lilia Vazquez Hernandez. A copy of this report and Appeal Rights were provided.

Page 2

NAME OF LICENSING PROGRAM MANAGER: Raul Navarro
NAME OF LICENSING PROGRAM ANALYST: Decondia Ferguson
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/01/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2026
LIC809 (FAS) - (06/04)
Page: 3 of 3