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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197414289
Report Date: 08/30/2019
Date Signed: 08/30/2019 03:36:06 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:GUTIERREZ FAMILY CHILD CAREFACILITY NUMBER:
197414289
ADMINISTRATOR:GUTIERREZ, ERICKAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
9099535522
CITY:COMPTONSTATE: CAZIP CODE:
90222
CAPACITY:14CENSUS: 2DATE:
08/30/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
02:36 PM
MET WITH:Licensee_Ericka GutierrezTIME COMPLETED:
03:47 PM
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Licensing Program Analyst (LPA) Reiko Jones-Modeste conducted an unannounced annual random inspection at the facility listed above. LPA met with Licensee, who guided analyst on a tour of the facility at side entrance. Upon arrival were, Licensee and two day care children. The licensee states that two adults (Licensee and husband) currently reside in the home. All adults present in the home have obtained a criminal record clearance or exemption prior to working, residing or volunteering in the licensed child care home. A current children’s Facility Roster was available for review.

This is a one-story home which consists of two bedrooms, one bathroom, kitchen, living room and backyard(fenced). The children use the bathroom located in the hallway, living room and kitchen. The restroom that children use was observed safe and sanitary. Per Licensee, areas off limits to children and parents include: all bedrooms. Appropriate sleeping arrangements (mats) were observed.

The Licensee provide all food for children in care Licensee states that there are no firearms stored in the home.

All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. There is telephone service via a landline and a cellphone which remains at the facility during operating hours. There is ventilation and heating (central). LPA observed open face heaters accessible to children with gas company waiver attached confirming gas shut-off..

Detergents, cleaning compounds, medications, and other items which could pose a danger to children were observed inaccessible to children. The licensee states that there are no poisons in the home and understands that storage areas for poisons must be locked with a key or combination lock. The valve on the required 2A 10BC fire extinguisher indicates fully charged and serviced on May 2019 as indicated on service tag. Smoke and carbon monoxide detectors were tested and operable.
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Reiko JonesTELEPHONE: (323) 558-2739
LICENSING EVALUATOR SIGNATURE:

DATE: 08/30/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2019
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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: GUTIERREZ FAMILY CHILD CARE
FACILITY NUMBER: 197414289
VISIT DATE: 08/30/2019
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The home was observed clean and orderly with age-appropriate toys and equipment available and free of sharp edges.

Currently, children are using the backyard for outdoor play time. The outdoor play area was observed fenced. LPA observed appropriate toys and equipment used for children. LPA observed one pet(dog) and one small shed locked and barricaded. LPA did not observe any objects that can pose a danger to children in the outdoor yard. The licensee states that supervision is always provided.

Children’s records were reviewed, including emergency information and were observed to be complete.

Licensee completed training on preventive health practices including Pediatric First Aid and CPR. The licensee's Pediatric First Aid and CPR expires on August 2020. There are first aid supplies available.

The Licensee provided proof of immunization against influenza, pertussis, and measles. LPA observed proof of the Mandated Reporter AB 1207 compliant Child Care Training Certificate on file for Licensee.

All homes shall conduct fire and disaster drills at least once every six months and document the date and time of each drill. LPA observed a current Disaster Drill log posted. Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed and posted.

LPA observed one pet at the facility during operating hours.

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 child care facility. Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.

Licensee states she is not currently caring for infants. Licensee states that she only provides care for toddlers and school-age children. LPA also consulted and explained Child Abuse Reporting, Updated Parent’s Rights Poster with Complaint Hotline information, Never Shake a Baby, and Safe Sleeping practices.

SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Reiko JonesTELEPHONE: (323) 558-2739
LICENSING EVALUATOR SIGNATURE:

DATE: 08/30/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2019
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: GUTIERREZ FAMILY CHILD CARE
FACILITY NUMBER: 197414289
VISIT DATE: 08/30/2019
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Incidental Medical Services (IMS):
The licensee states that she will not provide IMS. Per licensee, there are no children enrolled that require IMS at this time. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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: http://www.ada.gov/childqanda.htm.

LPA advised the licensee to access forms, regulations and quarterly updates on line at: www.ccld.ca.gov.

At this time, the licensee is in compliance with California Code of Regulations Title 22. No deficiencies cited.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit made by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

Exit interview was conducted with Licensee, including, Notice of Site Visit.
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Reiko JonesTELEPHONE: (323) 558-2739
LICENSING EVALUATOR SIGNATURE:

DATE: 08/30/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2019
LIC809 (FAS) - (06/04)
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