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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197700642
Report Date: 06/19/2023
Date Signed: 06/19/2023 02:50:36 PM

Document Has Been Signed on 06/19/2023 02:50 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: 6DATE:
06/19/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:35 PM
MET WITH:Gretchen Toledo-RodriguezTIME COMPLETED:
03:15 PM
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On 06/19/2023, Licensing Program Analyst (LPA) Justin Dorsey conducted a Capacity Increase Pre-Licensing inspection with Licensee, Gretchen Toledo-Rodriguez to ensure the facility meets basic licensing requirements set forth by Title 22, Health and Safety requirements. The Licensee is requesting to provide care for a Large family childcare home for the capacity of 14 children. Currently, there are 2 adults (including Licensee) living in the home. LPA toured the home indoor and out to ensure it meets FCCH requirements. The Licensee is requesting the days and hours of operation to be Monday through Friday 6:00am - 6:00pm.

The home is described as follows: This is a one story 2 bedroom, 2 bathroom home with office, kitchen, dining area, family room, living room, and garage. There is no pool on the premises.


Indoor: Main area: Main care is provided in the family room and living room. Children will have access to the living room, family room, children's bathroom and 1 bedroom. Off limit areas include the master bedroom, office, kitchen, and garage.

Bathroom: Children will use the bathroom in the hallway. The children's bathroom was toured, and inspected, toilets are in operable condition. Toilet and faucets are clean, safe, and operable; bathtub and shower area free of hazard. There are no medications or hazardous items stored in the medicine cabinet.

Kitchen: The kitchen is made inaccessible to children by gate. The refrigerator dishwasher, stove, microwave, etc., are clean. The kitchen was clean, orderly, and free of hazardous items. Medications are stored inaccessible high in a kitchen cabinet, knives are locked in a kitchen drawer and cleaning supplies are stored under the sink. Licensee will place a lock on the cabinet to ensure the cleaning supplies are not accessible.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Justin Dorsey
LICENSING EVALUATOR SIGNATURE: DATE: 06/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/19/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		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 CARE
FACILITY NUMBER: 197700642
VISIT DATE: 06/19/2023
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Outside: The backyard was inspected. The backyard is completely fenced, children will play outside only in the backyard. There is concrete and a wood chipped area under a play structure for children to play. LPA observed toys and play equipment in good condition. Per licensee the children only play on the concrete and wood chip area. The off limit areas of the backyard include the dirt and the area behind gates on the left and right side of the backyard.

Advisory/Other: First Aid kit was readily available. The licensees CPR/First Aid expires on 06/30/24. Mandated Reporter was completed 07/25/22. Children nap on cots, cribs and beds in the on limits bedroom. During the visit LPA Dorsey observed the homes carbon monoxide detector, smoke detector and 2A10BC fire extinguisher were in operable condition.

Documents discussed: Safe Sleep PIN 20-24-CCP, LIC 9227, Infant Safe Sleep Log and Large Family Child Capacity Worksheet.

Licensee was reminded that all adults 18 and over living or working in the home, 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.

LPA discussed the safe sleep regulations with the licensee 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 licensee 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.

A notice of site visit was given and must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted. Report and Appeal rights were reviewed with Licensee Gretchen Toledo-Rodriguez.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Justin Dorsey
LICENSING EVALUATOR SIGNATURE:

DATE: 06/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2023
LIC809 (FAS) - (06/04)
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