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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376102172
Report Date: 10/04/2024
Date Signed: 10/04/2024 03:18:26 PM

Document Has Been Signed on 10/04/2024 03:18 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
SAN DIEGO NORTH, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:TOBYA, ROVINA FAMILY CHILD CAREFACILITY NUMBER:
376102172
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
10/04/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:35 PM
MET WITH:Tobya RovinaTIME VISIT/
INSPECTION COMPLETED:
03:30 PM
NARRATIVE
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On October 4, 2024, at 1:35 PM, Licensing Program Analyst (LPA) Sherlynn Banas, conducted an announced Pre-Licensing inspection for the applicant. Upon arrival, LPA met with applicant Rovina Tobya. The one story home was toured and inspected to ensure an environment safe for the care and supervision of children. The fire extinguisher, carbon monoxide detector, and smoke detector meet requirements and are operational. All hazardous items were latched and secured out of reach of children. There is a pool at the home. It is self-latching and at least 5 inches high. There is a working phone at the facility. Applicant states that there are no weapons in the home. Applicant states that they have sufficient financial resources to sustain the license. CPR and First Aid will expire in August 2025. Preventative health practices course was completed on September 16, 2023, which includes lead poison prevention training. Mandated reporter training certificate expires on September 30, 2026. Staff immunization requirements were met. Applicant owns the home.

Applicant will be using the following rooms for childcare: living room, kitchen, dining room, bedroom 3, bathroom, backyard. Off-limits areas include bedroom 1,2, and 4, and garage. Verification of control of property is on file.

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, 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.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Sherlynn Banas
LICENSING EVALUATOR SIGNATURE: DATE: 10/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/04/2024
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 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO NORTH, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: TOBYA, ROVINA FAMILY CHILD CARE
FACILITY NUMBER: 376102172
VISIT DATE: 10/04/2024
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LPA reviewed with applicant the LIC 311D, Forms/Records to Keep in Your Family Childcare Homes, children’s forms/records, facility forms/records, and information to be posted. The new provider packet was reviewed with the applicant including information on child abuse and unusual incident reporting. LPA provided information regarding the YMCA Resource center. Applicant was reminded that corporal punishment, smoking, walkers, exersaucers, jumpers and bouncy seats are not allowed in day care. All equipment that is used should be used only as intended by the manufacturer. LPA and applicant discussed Shaken Baby Syndrome and California Megan's Law and LPA provided: www.meganslaw.ca.gov. LPA, Sherlynn Banas reviewed COVID-19 guidelines with Applicant and provided COVID-19 resources.

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.

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.

SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Sherlynn Banas
LICENSING EVALUATOR SIGNATURE:

DATE: 10/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2024
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
SAN DIEGO NORTH, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: TOBYA, ROVINA FAMILY CHILD CARE
FACILITY NUMBER: 376102172
VISIT DATE: 10/04/2024
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Incidental Medical services (IMS) policy was discussed. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Childcare 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.

A license for 8 children may be granted upon final file review. Applicant understands that she must obtain landlord consent to care for more than 6 children. Applicant agreed to comply with all regulations and laws governing family child-care homes.

No corrections at this inspection.

Exit interview conducted and Appeal Rights was provided. Report was reviewed with the applicant Rovina Tobya.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Sherlynn Banas
LICENSING EVALUATOR SIGNATURE:

DATE: 10/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2024
LIC809 (FAS) - (06/04)
Page: 3 of 3