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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197408665
Report Date: 02/10/2025
Date Signed: 02/10/2025 09:49:59 PM

Document Has Been Signed on 02/10/2025 09:49 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
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:GUTIERREZ FAMILY CHILD CAREFACILITY NUMBER:
197408665
ADMINISTRATOR/
DIRECTOR:		GUTIERREZ, HORTENCIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 301-9787
CITY:CULVER CITYSTATE: CAZIP CODE:
90230
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 7DATE:
02/10/2025
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:32 AM
MET WITH:Hortencia GutierrezTIME VISIT/
INSPECTION COMPLETED:
10:55 AM
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On 02/10/2025 Licensing Program Analyst (LPA) Ranita Richmond and Brittany Lovest arrived at the facility to conduct a Plan of Correction visit and was met by Licensees Hortencia Gutierrez and husband Raul Gutierrez. Adult resident Monica Gutierrez, and assistant Karla Nurinda were present during inspection. LPA observed 7 children in care being supervised and cared for by licensee and 2 fingerprint cleared assistants.

On 01/22/2025, Licensee was cited for the following:
1. The provider shall supervise infants while they are sleeping and adhere infant safe sleep, including documentation. Infants up to 12 month of age who are sleeping in a position other than on their back.
2. Licensee will ensure upon the provider’s observation that the infant is capable of rolling from their back to their stomach and stomach to their back, the provider shall fill out Section D of the Individual Infant Sleeping Plan.
3. Licensee will ensure that the family day care home shall maintain documentation of the required immunizations or exemptions from immunization, as set forth in this section, in the person's personnel record that is maintained by the family day care home.

During visit LPA Richmond and Lovest observed the following:
1. LPA reviewed infant sleep chart and observed positioning of infant sleep for infants up to 12 months of age is indicated as sleep on their back.
2. LPA reviewed infant files and observed Section D on LIC 9227 forms for children under the age of 12 months are signed by licensee.
3. On 02/06/2025 licensee emailed LPA copies of TB clearance for adults in the home.

3 of 3 Citations issued on 1/22/2025 has been cleared.

An exit interview was conducted. A copy of this report, notice of site visit, deficiencies clearance letters were discussed and provided to Licensee.
Claudia EscobedoTELEPHONE: (424) 301-3044
Ranita RichmondTELEPHONE: (424) 301-3065
DATE: 02/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/10/2025
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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