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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198016029
Report Date: 03/02/2026
Date Signed: 03/02/2026 01:26:32 PM

Document Has Been Signed on 03/02/2026 01:26 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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:BAROMA FAMILY CHILD CAREFACILITY NUMBER:
198016029
ADMINISTRATOR/
DIRECTOR:		BAROMA, NONAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 726-8268
CITY:GLENDALESTATE: CAZIP CODE:
91206
CAPACITY: 14TOTAL ENROLLED CHILDREN: 9CENSUS: 6DATE:
03/02/2026
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:20 AM
MET WITH:Nona BaromaTIME VISIT/
INSPECTION COMPLETED:
01:45 PM
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On 03/02/2026, at 11:20pm, Licensing Program Analyst (LPA) Shushanik Safaryan conducted an annual random inspection of the above facility. LPA met with Nona Baroma, Licensee to whom the reason for the visit was explained. Per Licensee, there are 9 children currently enrolled. There were 6 children and licensee`s assistant present upon arrival. Licensee`s husband and son came in later. The licensee was observed to be operating within the license capacity limitations.

During this inspection individuals who reside in the home were discussed and noted on Confidential Name List (LIC811) and attached to this report. Per licensee operation hours are Monday to Friday, 8:30 a.m. to 5:30 p.m.

During this visit, all areas identified that are accessible for children to use were inspected for safety, comfort, and cleanliness.
The is a two-story home which consists of 5 bedrooms, 3 bathrooms, kitchen, living room, dining room, covered patio, detached garage, front yard and backyard (fenced).
Per licensee, children use the one bedroom(family room)adjacent to the backyard, one bathroom in the hallway, living room, dining room, outdoor covered patio and back yard (fenced).
Per licensee areas off limits to children and parents include: kitchen, master bedroom on the first floor, bathroom in the master bedroom, bedroom in the hallway, entire second floor which consists of two bedrooms and one-bathroom, detached garage, and front yard.
**Rooms that are off-limits need to be made inaccessible during operating hours**

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NAME OF LICENSING PROGRAM MANAGER: Brandi VanOosten
NAME OF LICENSING PROGRAM ANALYST: Shushanik Safaryan
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 03/02/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/02/2026
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: BAROMA FAMILY CHILD CARE
FACILITY NUMBER: 198016029
VISIT DATE: 03/02/2026
NARRATIVE
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At 11:20 am, Licensee guided LPA to the tour of the home. LPA was toured starting from the living room where observed fireplace which was screened to prevent children’s access. LPA observed mats used for napping stored in the living room. Next LPA toured the dining room and observed dining table and chair. LPA observed child safety gate separating kitchen from the dining room. Children use bathroom in the hallway. LPA toured the bathroom and did not observe any hazards. LPA observed child safety gate was placed in the hallway to prevent children’s access to the off-limit areas. LPA toured the bedroom adjacent to the kitchen and back yard used for day care and observed 2 cribs. LPA observed infant in the crib placed on his back. LPA observed stairs leading to the second floor were blocked to prevent children access. LPA observed door leading to the kitchen from bedroom. Per licensee , this door is always locked from kitchen side. Per licensee, children use patio area most of the time when weather permits. In the patio area, LPA observed 5 children preparing to have a snack. LPA observed mini highchairs, small tables, and small chairs. LPA observed carts with children names , where children belongings stored. LPA toured the back yard area, observed grass and trees. LPA observed AC unit was blocked, and gates leading from the side of the property to outside observed locked.
Facility License, Emergency Disaster Plan, Parent’s Rights Poster, and Earthquake Preparedness Checklist were observed to be posted on the kitchen door from outside visible to the parents. At 11:40 am, LPA observed children’s roster was not available for review.

There is telephone service via a cellphone that stays at the facility during operation hours. There are central air and heating in the home.

Detergents, cleaning compounds, and medications were observed to be inaccessible to children. Per Licensee, there are no poisons in the home. LPA advised that any poison should be locked under key or combination lock. Licensee states that there are no firearms or weapons stored in the home.

The valve on the required 2A 10BC fire extinguisher indicates fully charged and LPA observed service tag with the service date 06/13/2025. Smoke and carbon monoxide detectors were observed in the hallway area.
All homes shall conduct fire and disaster drills at least once every six months and document the date and time of each drill. Last drill documented was conducted on 02/25/2026. The home is observed to be clean and orderly. There are first aid supplies available in the kitchen cabinet. There are age-appropriate toys available for children.
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NAME OF LICENSING PROGRAM MANAGER: Brandi VanOosten
NAME OF LICENSING PROGRAM ANALYST: Shushanik Safaryan
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/02/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2026
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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: BAROMA FAMILY CHILD CARE
FACILITY NUMBER: 198016029
VISIT DATE: 03/02/2026
NARRATIVE
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Per licensee, she does not provide food for children in care. Children bring their own lunches and snacks. Licensee was advised that if food is brought from the children’s homes, all containers must be labeled with child’s name and properly stored or refrigerated.
At 12:00pm, Licensee stated no weapons, firearms, pets or bodies of water in the facility.
At 12:00 pm Licensee records were reviewed. The licensee has completed training in Pediatric First Aid and CPR. The licensee's Pediatric First Aid and CPR expire on 01/2028.

At 12:00 pm, LPA did not observe that the Licensee does have proof of Mandated Reporter AB 1207 compliant Child Care Training Certificate on file. Licensee stated she did not renew her certificate. Last certificate observed by LPA was expired 07/2025 www.mandatedreporterca.com

Per licensee , she cares for 4 infants, one under 12 months and three over 12 months. LPA observed 15-minute checks and sleeping plan.

Children’s records were reviewed, including emergency information, and were observed to be complete.
LPA created LIC 857, Children’s Record Review and LIC 859 for Staff Record Review ,which documents staff and children’s files reviewed during this inspection.

Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.
LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs, and/or any other item that fall into these categories are not permitted in a family childcare facility.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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: https://www.ada.gov/resources/child-care-centers

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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. Page 3 of 4

NAME OF LICENSING PROGRAM MANAGER: Brandi VanOosten
NAME OF LICENSING PROGRAM ANALYST: Shushanik Safaryan
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/02/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2026
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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: BAROMA FAMILY CHILD CARE
FACILITY NUMBER: 198016029
VISIT DATE: 03/02/2026
NARRATIVE
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A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.
LPA discussed the safe sleep regulations with 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 [or facility representative] of the importance of checking for and removing any 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.

LPA advised the licensee how to access forms, regulations and quarterly updates on the Child Care Licensing website at www.ccld.ca.gov.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, the Licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Based on the LPA’s observations and records review, the following deficiencies listed on the attached LIC 809D (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.


LPA discussed all the deficiencies cited during today’s inspection with the licensee. Per licensee, she understands all the deficiencies and plans of correction .
A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee Nona Baroma on 03/02/2026.

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NAME OF LICENSING PROGRAM MANAGER: Brandi VanOosten
NAME OF LICENSING PROGRAM ANALYST: Shushanik Safaryan
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/02/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2026
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 03/02/2026 01:26 PM - It Cannot Be Edited


Created By: Shushanik Safaryan On 03/02/2026 at 01:03 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: BAROMA FAMILY CHILD CARE
FACILITY NUMBER: 198016029

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/02/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observations, records review and interview, the licensee did not comply with the section cited above. Licensee did not renew her Mandated Reporter Certificate , last certificate expired in 07/2025, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/16/2026
Plan of Correction
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 Licensee stated , she will complete the training and submit the certificate to LPA for review by POC date.
Type B
Section Cited
CCR
102417(g)(8)
Operation of A Family Child Care Home
(8) Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observations and records review, interview the licensee did not comply with the section cited above. LPA did not observe children roster, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/16/2026
Plan of Correction
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Licenseee stated , she will complete the roster and email to LPA for review by POC date.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Brandi VanOosten
NAME OF LICENSING PROGRAM MANAGER:
Shushanik Safaryan
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 03/02/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/02/2026


LIC809 (FAS) - (06/04)
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