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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400889
Report Date: 12/28/2023
Date Signed: 12/28/2023 02:49:47 PM

Document Has Been Signed on 12/28/2023 02:49 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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:WILCOX FAMILY CHILD CAREFACILITY NUMBER:
198400889
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
12/28/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Tonique Wilcox, ApplicantTIME COMPLETED:
03:15 PM
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On 12/28/2023 at 11:00 AM, Licensing Program Analyst (LPA)Katrina Chicote conducted an Announced – Prelicensing Inspection to the above facility. Upon arrival, LPA met with Applicant, Tonique Wilcox, who granted entry to facility and guided the LPA on a tour of the facility both indoors and outdoors, including off limits areas. Adults in the home were discussed and all have criminal record clearance. The Applicant is requesting a small family child care home license max capacity of 8 (has landlord consent on file). Per Applicant, operation hours will be seven days a week 24 hours caring for children 0-13 years of age. LPA discussed license limitations of not providing care for children longer than 23 hours and overnight care requirements per Title 22 Regulations at time of inspection.

All areas identified on the facility sketch were inspected, including but not limited to, off limit areas. This is a single-story home that consists of three bedrooms, two bathrooms, Dining Room, Living Room, Kitchen, and Laundry Room. Per Applicant, the children will have access to Living Room (located upon entry of the home), Dining Room (located to the rear of the home), and both bathrooms (located down hallway to the left). Per Applicant and Facility Sketch submitted, off limit areas of the home will be all three bedrooms, Laundry Room, and Kitchen. At 11:08 AM, LPA observed operable baby gates at entrances of Kitchen and Laundry Room making these areas off limits at time of inspection. Applicant states off limits bedrooms will be locked during operating hours, LPA observed bedroom doors to have locks available at time of inspection.

All areas identified on the facility sketch as accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for the safety of the children. There is a working telephone maintained in the home. At 11:03 AM, LPA observed Living Room to have two couches, arm chair, coffee tables, cubbies for storage of children's belongings, and half circle child size table and chairs available for children all well maintained. LPA observed a variety of age appropriate toys such as wooden blocks, plastic manipulatives, and large legos free of loose and sharp parts. Applicant states they will use Living Room as
Report Continues - Page 1 of 5
SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE: DATE: 12/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/28/2023
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 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: WILCOX FAMILY CHILD CARE
FACILITY NUMBER: 198400889
VISIT DATE: 12/28/2023
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isolation area for sick children. LPA observed electrical cover outlets all through the home. LPA observed a wall heater in Living Room that has been barricaded to make off limits at time of inspection. At 11:05 AM, LPA observed Dining Room to have soft rug, library area, and standard blue cots stored against wall. Applicant states they will use Dining Room area for overnight care. Applicant states she will provide food to children in care and use table in Living Room for eating. LPA observed Kitchen to have operable child safety locks on low cabinets and drawers including drawer where sharp knives and utensils are stored. At 11:07 AM, LPA observed both bathrooms to have adequate supplies, operable equipment, and general safety and sanitation. LPA observed operable child safety locks on under cabinet sinks at time of inspection. LPA observed another wall heater down hallway next to bathrooms that is barricaded making it off limits to children in care. Detergents, cleaning compounds, medications, and other items which can pose a danger to children are inaccessible. At 11:09 AM, LPA observed these items stored in high cabinet in Laundry Room with operable child safety locks at time of inspection. LPA observed medicines stored in high cabinet in hallway that has been locked with operable child safety locks at time of inspection. Applicant was advised that inaccessibility of hazards must be constantly reassessed depending on the age, size, and abilities of children in care. LPA advised that poisons used to kill any kind of bugs/vermin should be locked with a key or combination lock to be inaccessible for a variety of children's size, age, and abilities.

Per Applicant, the children will have access to front yard for outdoor play. At 11:15 AM, LPA observed front yard has grassy area, concrete walkway, and adequate perimeter fencing through-out. LPA observed swing set and slide on top of grassy area providing cushioning, plastic play house, and other age appropriate toys free of loose and sharp parts available for the children in the front yard. LPA observed all trees, shrubs, and plants are maintained at time of inspection. LPA observed an aloe vera plant in front yard in middle of play area that was removed by Applicant and placed in off limits backyard area at time of inspection. LPA discussed that plants with any sharp points need to be in area inaccessible to children.

LPA did not observe any pets at time of inspection and Applicant confirms she has no pets. Per Applicant, there are no weapons, firearms in the home and there are no bodies of water around the premises. LPA observation did not see any bodies of water around the premises or firearms/weapons at time of inspection.
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SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:

DATE: 12/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/28/2023
LIC809 (FAS) - (06/04)
Page: 2 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: WILCOX FAMILY CHILD CARE
FACILITY NUMBER: 198400889
VISIT DATE: 12/28/2023
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At 11:20 AM, LPA observed the valve on the required 2A 10BC fire extinguisher indicates fully charged with service tag dated 12/20/2023. LPA tested smoke and carbon monoxide detectors and observed to be in operable condition at time of inspection. LPA observed First Aid kit stored in hallway closet and was inventoried for necessary supplies. The Applicant has current Pediatric First Aid and CPR valid until 07/2025 and required AB1207 Mandated Reporter training completed on 09/18/2023. Proof of immunization against influenza, pertussis, and measles were readily available during today’s inspection.

The following was discussed with the Applicant:
· Individuals who are 18 years of age or older living in the home must obtain a criminal record clearance. Individuals within one month of their 18th birthday must be fingerprinted immediately. Civil Penalties will be assessed if not in compliance.
· 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 (TDAP, MMR, Influenza), 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 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 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 for a minimum of 3 years.
· No infant walkers, No Johnny jumpers, No saucer chairs, No incline sleepers or any other item that falls into that category are not permitted in the facility.
Report Continues - Page 3 of 5
SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:

DATE: 12/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/28/2023
LIC809 (FAS) - (06/04)
Page: 3 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: WILCOX FAMILY CHILD CARE
FACILITY NUMBER: 198400889
VISIT DATE: 12/28/2023
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· Inspection Authority: All adults living and working in the home shall be made of aware of the Department’s right to inspection 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.
· 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

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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)/ (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 https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/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.

Report Continues - Page 4 of 5
SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:

DATE: 12/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/28/2023
LIC809 (FAS) - (06/04)
Page: 4 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: WILCOX FAMILY CHILD CARE
FACILITY NUMBER: 198400889
VISIT DATE: 12/28/2023
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LPA advised the Applicant how to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov. LPA reviewed and issued the Forms/Records to Keep in Your Family Child Care Home (LIC 311D) and provided the forms referenced.

OTHER INFORMATION AND FORMS PROVIDED:
· Capacity Handout for a Small Family Child Care Home and Large Family Child Care Home was provided.
· Handout for Lead poisoning
· LIC 126 Family Child Care Home Entrance Checklist

Per Applicant, there are no dual licenses at this address. Applicant’s email address was obtained during this inspection. The Applicant was advised that email may be public information.

Based on LPA's observation today 12/28/2023, Applicant will be approved to operate a small family child care home license (max capacity 8). The Applicant is required to comply with the terms and limitations stated on the license.

Exit interview was conducted and report was reviewed with the Applicant, Tonique Wilcox.

Report Ends - Page 5 of 5
SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:

DATE: 12/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/28/2023
LIC809 (FAS) - (06/04)
Page: 5 of 5