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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198017254
Report Date: 10/26/2021
Date Signed: 10/26/2021 05:08:29 PM

Document Has Been Signed on 10/26/2021 05:08 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:TOMAS FAMILY CHILD CAREFACILITY NUMBER:
198017254
ADMINISTRATOR:TOMAS, FRANCISFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 927-4853
CITY:BELL GARDENSSTATE: CAZIP CODE:
90201
CAPACITY: 14TOTAL ENROLLED CHILDREN: 10CENSUS: 6DATE:
10/26/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
04:32 PM
MET WITH:Francis Tomas, LicenseeTIME COMPLETED:
05:18 PM
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Licensing Program Analyst (LPA) Alicia Mooberry conducted an unannounced Case Management visit for the purpose of interviewing children in care. LPA met with Francis Tomas, Licensee who provided tour of the home. Children's files were reviewed and parent contact information was obtained. An updated Children's Roster was obtained.
There were 6 children present, 4 of which were napping. Also present was the licensee's spouse and adult daughter
No deficiencies were observed in the areas that were evaluated during this visit.

Exit interview was conducted with Francis Tomas, Licensee.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE: DATE: 10/26/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/26/2021
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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