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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198004496
Report Date: 02/26/2020
Date Signed: 02/26/2020 03:30:26 PM

COMPREHENSIVE INSPECTION
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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:GONZALES FAMILY CHILD CAREFACILITY NUMBER:
198004496
ADMINISTRATOR:GONZALES, ELIZABETHFACILITY TYPE:
810
ADDRESS:TELEPHONE:
5626936045
CITY:WHITTIERSTATE: CAZIP CODE:
90603
CAPACITY:14CENSUS: 7DATE:
02/26/2020
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME BEGAN:
12:57 PM
MET WITH:Elizabeth GonzalesTIME COMPLETED:
03:43 PM
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Licensing Program Analyst (LPA) Jose Guzman and Licensing Program Manager (LPM) Ana Chico conducted an annual required inspection. LPA and LPM met with Ashley Gonzales, assistant, who advised that licensee would arrive shortly. Licensee, Elizabeth Gonzales, arrived approximately five minutes later and proceeded to guide LPA and LPM on a tour of the facility. This is a single story home which consists of 4 bedrooms and 2 bathrooms. Also present was Licensee's adult son. There were 7 children present during today’s inspection. Licensee states that there are currently 11 children enrolled. The children's roster was reviewed and is current. Disaster drill log was also available during today’s inspection. Last drill conducted on February 2020. Day Care days and hours are: M-F 6:00 PM- 6:00PM.
Areas accessible to children were inspected as follows: Den area that is converted into day care area, one bathroom in hallway, back yard, kitchen, living room and dining room.
Areas off limits include: Four bedrooms (one bedroom located next to day care room(den), bathroom and front yard.
Areas accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for the safety of the children. There is a working telephone maintained in the home. Family members residing in the home are four adults (criminal record clearances on file) and no children. Licensee has two pet dogs. Detergents, cleaning compounds, medications, and other items which can pose a danger to children are inaccessible. The Licensee states that there are no poisons in the home. The Licensee does understand that poison must be locked with a key or combination lock.
Per Licensee, there are no weapons, firearms or bodies of water on the premises. The backyard is adequately fenced. There are safe toys, play equipment and materials observed for children. Emergency Disaster was posted at the time of inspection but must be updated to reflect current Licensee’s information. Children’s records were reviewed to ensure that each child has an Identification and Emergency form. The valve on the required 2A 10BC fire extinguisher indicates fully charged, serviced on 02/14/2020.

Report continues- Page 1 of 3
SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Jose GuzmanTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 02/26/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2020
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 4
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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: GONZALES FAMILY CHILD CARE
FACILITY NUMBER: 198004496
VISIT DATE: 02/26/2020
NARRATIVE
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Smoke and carbon monoxide detector in the living room was tested and is in operable condition. The Licensee and assistant have current Pediatric First Aid and CPR, which will expire on 01/2021 and 12/2020 respectively. Proof of immunization against influenza, pertussis, and measles was readily available during today’s inspection. The Licensee and assistant have also taken the Mandated Reporter Training but has expired and needs to be renewed.
The following was discussed: Individuals who are 18 years of age or older living in the home must obtain a criminal record clearance. Individuals within one month of their 18th birthday must be fingerprinted immediately. Failure to obtain a criminal record background check clearance prior to initial presence in the home will result in an immediate $100.00 dollar or more per day Civil Penalty.

Rooms that are off-limits need to be made inaccessible during operating hours. No smoking, No infant walkers, No Johnny jumpers, No saucer chairs, No trampolines and any other item that falls into that category are not permitted in the facility. Effective January 1, 2010, licensees of family childcare homes are required to ensure that at least one staff member with current training in pediatric first aid and pediatric CPR is on site at all times when children are present.

Role and responsibilities of being a Mandated Reporter were reviewed. The Licensee was advised how to access forms and Regulations online at www.ccld.ca.gov. Licensee was made aware that it is his/her responsibility to know the regulations as well as anyone who assists in providing care.

The Licensee was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care. Sudden Infant Death Syndrome (SIDS) and Never-Shake-a-Baby were discussed. A hard copy of A Child Care Provider’s Guide to Safe Sleep was provided. Also provided was the Department's brochure on the Effects of Lead Exposure.

Report continues- Page 2 of 3

SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Jose GuzmanTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 02/26/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2020
LIC809 (FAS) - (06/04)
Page: 2 of 4
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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: GONZALES FAMILY CHILD CARE
FACILITY NUMBER: 198004496
VISIT DATE: 02/26/2020
NARRATIVE
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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 The licensee’s email address was obtained during this inspection. The licensee was advised that email is public information.

LPA issued the Confidential Names List (LIC 811) to the licensee during this visit. The Confidential Names List documents the children’s files that were reviewed during this inspection.

Per licensee, she does not carry liability insurance. The law requires Family Child Care provider to carry liability insurance or bond in the amount of $300,000 annually or to maintain the singed statement in the facility file. LPA advised the licensee how to access forms, regulations and quarterly updates, and provider information notices (PIN) on line at: www.ccld.ca.gov


LPA explained Child Abuse Reporting, Updated Patent’s Rights Poster with Complaint Hotline information. Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing. (use LIC624) for written report). Licensees shall reveal each facility license number in all advertisements, publications, or announcements made with the intent to attract clients.

The deficiencies listed on the following page were observed by the LPA and are being cited in accordance with California Code of Regulations Title 22. Please see attached LIC 809-D. Deficiencies that are being cited need to be cleared to protect the children’s health & safety. Licensee was advised that an office meeting will be scheduled to discuss recently cited deficiencies. TSP was also discussed with Licensee during this inspection.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site inspection 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, Elizabeth Gonzales. The Licensee was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these forms. Page 3 of 3

SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Jose GuzmanTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 02/26/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2020
LIC809 (FAS) - (06/04)
Page: 3 of 4
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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: GONZALES FAMILY CHILD CARE
FACILITY NUMBER: 198004496
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/26/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/13/2020
Section Cited

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On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child 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
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following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by LPA reviewing staff files and for Licensee and assistant the certificate of AB1207 on their files needs to be renewed. This is a potential health & safety risk to children in care.
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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: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Jose GuzmanTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 02/26/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/26/2020
LIC809 (FAS) - (06/04)
Page: 4 of 4