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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197700642
Report Date: 04/07/2023
Date Signed: 04/07/2023 02:57:25 PM

Document Has Been Signed on 04/07/2023 02:57 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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:TOLEDO RODRIGUEZ FAMILY CHILD CAREFACILITY NUMBER:
197700642
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 5DATE:
04/07/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:38 PM
MET WITH:Gretchen Toledo-RodriguezTIME COMPLETED:
03:11 PM
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On 03/15/22 Licensing Program Analyst (LPA) Justin Dorsey, met with Licensee Gretchen Toledo-Rodriguez, for a Case Management - Other inspection.

During the inspection the following was observed:
  • LPA Dorsey observed a baby bouncer and baby rocker in the homes living room. Per licensee children of the program do not use the equipment and is only used for the licensees child. LPA Dorsey reminded licensee that the equipment can not be used for children in care. During the visit LPA Dorsey observed all banned equipment was moved to the garage.

LPA Dorsey issued a Technical Violation on 04/07/23. An exit interview was conducted, a copy of this report was read and provided to Licensee, Gretchen Toledo-Rodriguez. .
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Justin Dorsey
LICENSING EVALUATOR SIGNATURE: DATE: 04/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/07/2023
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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