<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020227
Report Date: 04/26/2024
Date Signed: 04/26/2024 02:58:15 PM

Document Has Been Signed on 04/26/2024 02:58 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:TOLIVER FAMILYCHILD CAREFACILITY NUMBER:
198020227
ADMINISTRATOR/
DIRECTOR:		ERINN S. TOLIVERFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(424) 205-7584
CITY:CARSONSTATE: CAZIP CODE:
90746
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 6DATE:
04/26/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:40 PM
MET WITH:Licensee Erinn ToliveraTIME VISIT/
INSPECTION COMPLETED:
03:15 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analysts (LPA) Anthony Padilla and Susann Sanchez conducted an unannounced annual required inspection at the above facility on 04/26/2024 at 12:45 PM. LPA met with Erinn Toliver, Licensee who guided analysts on a tour of the facility. There were 5 children, 1 infant, and 2 adults present when LPA arrived. Facility capacity is in compliance for a Large Family Child Care Home. Hours of operation are Mon-Fri 5:30AM - 6:00PM. Food is provided by Licensee. Licensee was reminded if children bring food from home it must be labeled with the child’s name and properly stored or refrigerated.

All areas in the facility sketch were inspected that are used by children in care. This is a two-story home which consists of 4 bedrooms, 2 full restrooms, kitchen, living room, dining room, attached garage, front yard (not fenced), & backyard (fenced) with pool (fenced). Off limits include: All upstairs (3 bedrooms and 1 full restroom), attached garage, and back yard. LPA observed a safety gate at the bottom of the stairs to prevent access to the upstairs and a safety gate at the top of the stairs. Areas used for daycare are: living room/daycare room, restroom in the hallway, downstairs bedroom (just as a walkway to the backyard), and backyard.

All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. The following was observed and reviewed during this inspection:

LPA reviewed required posted documentation for Facility License, Publication (PUB) 394- Notification of Parent Rights and Licensing Form (LIC) 9148- Earthquake Preparedness form. Facility records were reviewed for LIC 9040- Facility Roster, LIC 610- Facility Disaster Plan and Disaster drill log, last drill conducted on 3/12/24.

Smoke and carbon monoxide detectors were not tested due to children napping. Licensee will show proof of operable carbon monoxide and smoke detector and submit proof via cell phone video to LPA. Fire extinguisher was observed to be fully charged and was serviced on 4/15/24.
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Anthony Padilla
LICENSING EVALUATOR SIGNATURE: DATE: 04/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/26/2024
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 6
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: TOLIVER FAMILYCHILD CARE
FACILITY NUMBER: 198020227
VISIT DATE: 04/26/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
The home maintains telephone service via cell phone. The home is observed to be clean and orderly. There are toys and other age appropriate material available for children. Fireplace is located in the living/daycare room and was observed to be gated off. LPA observed that detergents, cleaning compounds and medication are stored in the locked kitchen cabinet under the sink and some in the garage, inaccessible to children. Licensee states that there are no poisons stored in the home and understands that all poisons must be lock, not only inaccessible to children. Isolation area for sick children waiting to be picked up is in the living room/daycare room behind the desk, away from the other children. Per Licensee there are no firearms or weapons stored in the home.

At 12:50pm, Licensee stated that assistant Monqiue Wallace just started working today (04/26/24) for a short time since Licensee previous assistant is no longer working at facility. Licensee and assistant understand that she cannot work at the facility until fingerprints are cleared. Assistant immediately left facility. Type A was cited.

Licensee stated the front yard and walks to Mills Park will be used for outdoor play. LPAs toured the backyard. The backyard has a pool that meets the Title 22 requirements. Licensee stated that children do not use the backyard when it's cold or after a rainy day due to debris. There is also a bell that rings when the back door leading to the pool is open.

Currently licensee only has 1 infant enrolled. LPA observed 0 play yards/cribs. Per Licensee infants are over 12 months and sleep on cot. Napping equipment does not block entrances or exits. LPA reviewed the following in case Licensee decides to get cribs/ play yards in the future. Infant mattresses need to be firm with tightly fitted sheets. Loose object, bumpers, objects hanging, or objects attached to the cribs/play yards are not allowed.

Children’s records were reviewed for (LIC) 282- Affidavit Regarding Liability Insurance, Immunization Records, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights, LIC 9227- Infant sleep form (0-12 months, and documentation of 15-minute Infant Sleep Check (0-24 months)


Staff records were reviewed for approved Pediatric First Aid and CPR certification and expires on 01/2026.

At 1:30pm, during staff file review, Licensee stated that she has not renewed her Mandated Reporter Training. Per Licensee she thought certificate was good for 3 years. Type B was cited.

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Anthony Padilla
LICENSING EVALUATOR SIGNATURE:

DATE: 04/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/26/2024
LIC809 (FAS) - (06/04)
Page: 2 of 6
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: TOLIVER FAMILYCHILD CARE
FACILITY NUMBER: 198020227
VISIT DATE: 04/26/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
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.

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. 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 [or facility representative] and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee [or facility representative] 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. When any IMS is provided, an updated Plan of Operation that includes 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Anthony Padilla
LICENSING EVALUATOR SIGNATURE:

DATE: 04/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/26/2024
LIC809 (FAS) - (06/04)
Page: 4 of 6
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: TOLIVER FAMILYCHILD CARE
FACILITY NUMBER: 198020227
VISIT DATE: 04/26/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
During the exit interview, the LICENSEE Erinn Toliver, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled children for the next 12 months (1 year). The Acknowledgement form must be maintained in each child’s file immediately upon receipt from parent. Licensee was provided with a copy of the parent Acknowledgement of Receipt of Licensing Reports Form during this visit. A copy of the Parent Notification Requirements was also provided to the licensee.

The following deficiencies listed on the attached LIC 809 (deficiency page) are being cited in accordance with California Code of Regulations Title 22, Division 12, Chapter 1 and Section CCR & H&S.



A notice of site visit was given and must remain posted for 30 days. Appeal Rights were given and explained. Exit interview conducted and report was reviewed with the Licensee, E. Toliver.
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Anthony Padilla
LICENSING EVALUATOR SIGNATURE:

DATE: 04/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/26/2024
LIC809 (FAS) - (06/04)
Page: 3 of 6
Document Has Been Signed on 04/26/2024 02:58 PM - It Cannot Be Edited


Created By: Anthony Padilla On 04/26/2024 at 02:25 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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: TOLIVER FAMILYCHILD CARE
FACILITY NUMBER: 198020227

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/26/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102370(d)
Criminal Record Clearance
(d) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility:

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, interview, record review, the licensee did not comply with the section cited above. LPAs observed an unfingerprinted adult. Licensee stated that assistant Monqiue Wallace is not fingerprinted. This poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 04/27/2024
Plan of Correction
1
2
3
4
Licensee and assistant understand that she cannot work at the facility until fingerprints are cleared. Assistant immediately left facility.
Section Cited
Deficient Practice Statement
1
2
3
4
POC Due Date:
Plan of Correction
1
2
3
4
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Karen Chambers
LICENSING EVALUATOR NAME:Anthony Padilla
LICENSING EVALUATOR SIGNATURE:
DATE: 04/26/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/26/2024


LIC809 (FAS) - (06/04)
Page: 5 of 6
Document Has Been Signed on 04/26/2024 02:58 PM - It Cannot Be Edited


Created By: Anthony Padilla On 04/26/2024 at 02:25 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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: TOLIVER FAMILYCHILD CARE
FACILITY NUMBER: 198020227

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/26/2024

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
1
2
3
4
Based on observation, interview and record review, Licensee did not renew the mandated reporter training, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/27/2024
Plan of Correction
1
2
3
4
Licensee will complete the training and licensee will email the certification to LPA's email by 05/27/2024
Section Cited
Deficient Practice Statement
1
2
3
4
POC Due Date:
Plan of Correction
1
2
3
4
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Karen Chambers
LICENSING EVALUATOR NAME:Anthony Padilla
LICENSING EVALUATOR SIGNATURE:
DATE: 04/26/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/26/2024


LIC809 (FAS) - (06/04)
Page: 6 of 6