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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198021618
Report Date: 12/30/2024
Date Signed: 12/30/2024 11:11:14 AM

Document Has Been Signed on 12/30/2024 11:11 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:HOLCOMB FAMILY CHILD CAREFACILITY NUMBER:
198021618
ADMINISTRATOR/
DIRECTOR:		HOLCOMB, LEAH J.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 497-3781
CITY:DUARTESTATE: CAZIP CODE:
91010
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
12/30/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Leah Holcomb, ApplicantTIME VISIT/
INSPECTION COMPLETED:
11:30 AM
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On 12/30/24 Licensing Program Analyst (LPA) Saul Valenzuela conducted a pre-licensing inspection to inspect and evaluate facility for a Large Family Child Care Home relocation. Applicant is relocating Holcomb Family Child Care (#198018375)) from 1183 Bradbourne Ave., Duarte, CA 91010 to a new location at 1143 Highland Ave., Duarte, CA 91010. At 9:30 a.m. LPA met with applicant Leah Holcomb, who guided LPA on a tour of the facility. The applicant is requesting a relocation of her family child care home license. Per applicant, operation hours will be Monday to Sunday, 5:00 a.m. to 4:00 a.m. Applicant states that she will care for children from birth - 17 years of age.

All areas identified on the facility sketch were inspected, including but not limited to, off limit areas. This is a two-story home that consists of 3 bedrooms, 3 bathrooms, dining room, living room, kitchen, garage, and, fenced back patio.

Per applicant, the children will use the living room, dining room, kitchen, bathroom located next to kitchen, and patio which is fenced. Areas that will be used by children were inspected for safety, comfort, cleanliness, telephone service (cell phone), ventilation and heating.

Based on the Facility Sketch submitted, areas off-limits to children and parents are: 3 bedrooms, 2 bathrooms, and garage. Applicant has made the second story of the home inaccessible by placing a child proof security gate at the bottom of the stairs.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Saul Valenzuela
LICENSING EVALUATOR SIGNATURE: DATE: 12/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/30/2024
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 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: HOLCOMB FAMILY CHILD CARE
FACILITY NUMBER: 198021618
VISIT DATE: 12/30/2024
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Detergents, cleaning compounds, medicines, sharp objects and hazardous items that can pose a danger to children were observed to be inaccessible in areas designated for children. Per applicant there are no poisons on premises. Applicant was advised that any poisons must be locked with a key or combination lock.

The children will use the fenced patio for outdoor play. LPA observed appropriate toys for children to use.



Per applicant, there are no pets on premises. Applicant states there are no firearms, weapons, bodies of water on the premises, and none were observed by LPA on this date. LPA observed a fireplace in the living room, which it is barricaded and inaccessible to children.

The valve on the 2A10BC fire extinguisher indicates fully charged and was serviced on 8/26/24 as indicated on the service tag. Smoke and carbon monoxide detectors were tested on this day and are operable.

LPA observed toys available for children and sleeping arrangements in the form of cots and a playpen were observed.

The applicant states that she will provide food for children in care and is in the food program.

The applicant has completed the required Health and Safety Training, including Nutrition and Lead Training and First Aid and CPR. There are first aid supplies available. The required AB1207 Mandated Reporter Training Certificate is current and on file for applicant.


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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Saul Valenzuela
LICENSING EVALUATOR SIGNATURE:

DATE: 12/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/30/2024
LIC809 (FAS) - (06/04)
Page: 2 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: HOLCOMB FAMILY CHILD CARE
FACILITY NUMBER: 198021618
VISIT DATE: 12/30/2024
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At 11:00 AM The following was discussed with the applicant:

· In the absence of the licensee a qualified adult must be present supervising the children; a qualified adult is an individual who has a valid and current Pediatric First Aid and CPR training, Immunizations (Pertussis, Measles, Influenza), current mandated reporter training, and a valid criminal record clearance associated to the facility license.
· Annual fees must be paid promptly and by the due date or a late fee shall be assessed and/or the License may be terminated.
· The fire extinguisher type 2A-10BC must be serviced or replaced annually or as often as necessary. Smoke and carbon monoxide detectors should be checked, and batteries replaced as needed.
· Reporting Requirements: Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your home.
· Reporting Requirements: Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing.
· Fire and safety drills must be performed every six months and the date and time documented for review by the Department.
· Smoking is prohibited in a family child care home.
· Children and Staff records must be maintained and updated as needed and must be available for review by the Department.
· Infant walkers, Johnny Jumpers, saucer chairs, and any other item that fall into that category are not permitted in the facility.
· All adults living and working in the home shall be made of aware of the Department’s right to inspect the home, which includes, but is not limited to the right to enter the home when children are being cared for, interview children and adults, and review documentation.
· The facility license number must be on all advertisements, publications or announcements with the intent to attract clients.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Saul Valenzuela
LICENSING EVALUATOR SIGNATURE:

DATE: 12/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/30/2024
LIC809 (FAS) - (06/04)
Page: 3 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: HOLCOMB FAMILY CHILD CARE
FACILITY NUMBER: 198021618
VISIT DATE: 12/30/2024
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·Isolation for Ill children: When a child is ill, he/she shall be separated from other children (reference 102417(e) Operation of a Family Child Care Home).
· Liability Insurance was discussed; LPA advised applicant to review Title 22 Regulation 102417(m)(1) for additional information.

· Immunization Requirement: H&S 1597.622: Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. The licensee and all adults working with children have proof of immunizations.

· Mandated Reporter Training: H&S 1596.8662: Beginning January 1, 2018, all licensed providers, applicants, directors and employees to complete training as specified on mandated reporter duties. Training is available at: www.mandatedreporterca.com

LPA advised the applicant how to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.



Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-carelicensing/ subscribe and select the Child Care option to receive email communication.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Saul Valenzuela
LICENSING EVALUATOR SIGNATURE:

DATE: 12/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/30/2024
LIC809 (FAS) - (06/04)
Page: 4 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: HOLCOMB FAMILY CHILD CARE
FACILITY NUMBER: 198021618
VISIT DATE: 12/30/2024
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Per applicant, there are no dual licenses at this address. Applicant does not wish to have an email address added to the facility profile at this time. The applicant was advised that email may be public information.

The applicant’s signature on this report acknowledges that they have signed the Application for a Large Family Child Care Home License (LIC 279) under the penalty of perjury that the statements on the application and any attachments are correct.

Applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.

The applicant provided proof of control of property.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (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.

LPA discussed the safe sleep regulations with applicant and discussed the Child Care Licensing Safe Sleep webpage at:

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Saul Valenzuela
LICENSING EVALUATOR SIGNATURE:

DATE: 12/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/30/2024
LIC809 (FAS) - (06/04)
Page: 5 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: HOLCOMB FAMILY CHILD CARE
FACILITY NUMBER: 198021618
VISIT DATE: 12/30/2024
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https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/ safe-sleep, as an additional resource. LPA also informed applicant 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.

On this date, 12/30/24, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility address. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

Applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.
Applicant is seeking to provide care for up to 14 children, aged birth-17 years old.

Based upon today’s inspection, there are no corrections pending at this time. The Family Child Care Home appears to meet Title 22 requirements. The application for relocation will be submitted for final review to the Department. Once licensed, the applicant is required to adhere to the terms and limitations stated on the license.

A notice of site visit was given to applicant and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

Exit interview conducted and report was reviewed with the applicant, Leah Holcomb.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Saul Valenzuela
LICENSING EVALUATOR SIGNATURE:

DATE: 12/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/30/2024
LIC809 (FAS) - (06/04)
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