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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400638
Report Date: 09/02/2022
Date Signed: 09/02/2022 01:20:45 PM

Document Has Been Signed on 09/02/2022 01:20 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:TOMA FAMILY CHILD CAREFACILITY NUMBER:
198400638
ADMINISTRATOR:ZOILA TOMAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 988-7652
CITY:LAKEWOODSTATE: CAZIP CODE:
90715
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
09/02/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:38 AM
MET WITH:Zoila Toma, ApplicantTIME COMPLETED:
01:32 PM
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On Friday, September 2, 2022 at 10:38 a.m., Licensing Program Analyst (LPA) Mayra Rivera conducted an announced pre licensing inspection and met with applicant Zoila Toma who guided LPA Rivera on a tour of the facility.

Family members residing in the home has been discussed with applicant and are cleared. Operating hours are Monday to Friday from 6:30 a.m. to 10:00 p.m. and care for children ages 0 to 12.

This facility is a one-story home that consists of three bedrooms two full bathrooms, kitchen, living room, den area and front yard and backyard. All areas identified on the facility sketch were inspected. Areas that are accessible to children and identified on the facility sketch include; den (daycare area), bathroom (daycare area), side yard and back room (converted garage).

Areas off limits to children include- 3 bedrooms and bathroom (located in the hallway), kitchen, living room and front yard. LPA observed the bedrooms and bathroom doors closed and locked making it inaccessible to children to open the doors.

At 10:55 a.m LPA Rivera inspected the facility for safety, comfort, cleanliness, ventilation and working phone (cell phone and land line). For ventilation, LPA Rivera observed AC wall units and the heater vent on the floor in the main living room and hallway (off limits area). LPA observed the furniture, children materials to be in good condition and age appropriate. LPA observed a safety gate anchored in front of the opening of the fireplace. The fireplace is non-operable. Applicant stated, she is in the process of adding a sliding door between the daycare room and living room (estimated date 10/17/22),
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Mayra Rivera
LICENSING EVALUATOR SIGNATURE: DATE: 09/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/02/2022
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: TOMA FAMILY CHILD CARE
FACILITY NUMBER: 198400638
VISIT DATE: 09/02/2022
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At approximately 11:10 a.m, LPA Rivera entered the restroom and observed the toilet, hand washing sink, and hand soap. LPA observed the bottom cabinets closed with child proof locks making it inaccessible for children to open the cabinets doors. LPA did not observe hazard materials and observed the restroom to be in good condition.

At approximately 11:16 a.m. LPA observed cleaning compounds items stored inside the bottom kitchen cabinets and laundry room with child proof locks making it inaccessible for children to open cabinet doors. Knives and sharp objects are stored inside the kitchen top cabinet making it inaccessible for children to reach. For drinking water, LPA observed two water dispensers for indoor and outdoor.

LPA Rivera asked applicant if there are any pets, poisons, firearms, weapons or bodies of water. Applicant stated she has no pets, no bodies of waters, firearms, weapons or poisons. LPA did not observe pets, firearms, weapons, poisons nor bodies of water. Applicant was advised that if any poisons (ex; drano, rat poison or items with skull hazard symbol), firearms and weapons are purchased, it is required to be locked with a key or combination lock and firearm and ammunition must be stored separately.



At 11:25 a.m. LPA Rivera observed the required 2A10BC fire extinguisher located in the daycare room, back room and the valve on the green area indicating fully charged and purchase receipts dated 8/17/22 and 8/22/22 . LPA observed carbon monoxide detectors in the daycare room and back room. The detectors were tested, and LPA Rivera heard the sound. The smoke and carbon detectors are operable. LPA observed the First Aid complete with band aids, gauzes, adhesive bandages and located in the daycare room.

At approximately 11:35 a.m, LPA Rivera inspected the outdoor area for safety, comfort and cleanliness. LPA observed children materials and play equipment to be in good condition and age appropriate. LPA did not observe any climbing or playground structure. LPA observed the side yard and backyard to be fenced and gated. LPA also observed the side gates closed with a self-latch and with a keypad lock.

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Mayra Rivera
LICENSING EVALUATOR SIGNATURE:

DATE: 09/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2022
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: TOMA FAMILY CHILD CARE
FACILITY NUMBER: 198400638
VISIT DATE: 09/02/2022
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At approximately 12:29 LPA Rivera observed LIC 9151 Property Owner /Landlord Notification and deed of trust. Applicant Pediatric First Aid/ CPR certification with expiration date 7/9/2024, Health and Safety certification dated 7/10/22 and applicant has proof of immunization against Pertussis, MMR and Influenza. Applicant has completed the mandated reporter (AB 1207) training on 1/19/2021. Applicant was advised that the mandated reporter training must be completed every 2 years, and is available at www.mandatedreporterca.com

LPA did not observe LIC 610A Emergency Disaster Plan, Pub 394 Notification of Parents Rights, LIC 999 Facility sketch, child car seat law posted on a bulletin board by the main entrance.



Criminal Record Statement

Applicant Zoila Toma 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, 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.

Safe Sleep

LPA discussed the safe sleep regulations with applicant Zoila Toma 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 applicant Zoila Toma 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.

This facility plans to provide Incidental Medical Services – IMS. For IMS information , see PIN 22-02-CCP. 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)/ (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

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Mayra Rivera
LICENSING EVALUATOR SIGNATURE:

DATE: 09/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2022
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: TOMA FAMILY CHILD CARE
FACILITY NUMBER: 198400638
VISIT DATE: 09/02/2022
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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 platform.

To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

No corrections needed and exit interview conducted and report was reviewed with the Applicant Zoila Toma.

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Mayra Rivera
LICENSING EVALUATOR SIGNATURE:

DATE: 09/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2022
LIC809 (FAS) - (06/04)
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