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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198004496
Report Date: 08/03/2021
Date Signed: 08/03/2021 11:53:07 AM

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:
(562) 693-6045
CITY:WHITTIERSTATE: CAZIP CODE:
90603
CAPACITY:14CENSUS: 7DATE:
08/03/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:05 AM
MET WITH:Elizabeth GonzalezTIME COMPLETED:
12:15 PM
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Licensing Program Analyst (LPA) Alanna Gontarek conducted an unannounced annual inspection to the above facility. LPA met with Elizabeth Gonzalez, Licensee who guided analyst on a tour of the facility indoors and outdoors. Also present during this inspection, was Licensee’s adult son and adult daughter. Per Licensee, there are 8 children that are currently enrolled. The Licensee is within the conditions, limitations, and capacity specified on the license. A current children’s roster was available for review. There were 7 children present upon arrival. Hours of operation are: Monday to Friday from 7:00 a.m. to 6:00 p.m. LPA observed Licensee, Licensee's adult son, and Licensee's adult daughter and children not wearing face masks. LPA advised Licensee to wear face masks while inside due to COVID-19 preventative measures.

This is a one-story home which consists of 4 bedrooms, 2 bathrooms. Licensee has 3 small pet dogs.
Areas accessible to children were inspected as follows: Den area, play room, living room, one bathroom in hallway, back yard, kitchen, living room and dining room.

Areas off limits include: Four bedrooms, Licensee's bathroom, garage, and front yard. The licensee provides fresh perishable and non-perishable food in the home in a quantity and quality to meet the needs of the next 3 meals and between meal snacks.
The licensee states that 2 additional adults (Licensee's adult children) live in the home. Per Licensee, she currently has 2 assistants. Licensee states that her son, Dominick, and daughter, Ashley are the Assistants. All adults present in the home have obtained a criminal record clearance prior residing in the licensed Child Care home. Licensee states that there are no firearms, or firing pins, stored in the home. Home maintains appropriate fire clearance.

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 that is used and the cellphone stays at the facility during operation hours. There is ventilation, heating, and air conditioning (central).

Per licensee, isolation area is in the play area, where the child will be constantly observed and supervised.
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-8417
LICENSING EVALUATOR NAME: Alanna GontarekTELEPHONE: (323) 854-8644
LICENSING EVALUATOR SIGNATURE:

DATE: 08/03/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2021
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: 08/03/2021
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The following was observed and reviewed during this inspection:
Detergents, cleaning compounds, medications, and other items which could pose a danger to children were observed to be inaccessible to children. LPA observed cleaning compounds to be located under kitchen sink in a latched cabinet. Per licensee, medications are stored in an above latched cabinet in the kitchen, to the right of the sink. The licensee states that there are poisons in the home and understands that storage areas for poisons must be locked with a key or combination lock. Per Licensee, poisons are stored in a locked garage.
Fireplaces and open face heaters are inaccessible to children. LPA observed a fireplace located in living room, and has a safety lock on front doors. The valve on the required 2A 10BC fire extinguisher indicates fully charged and was serviced on 04/21/21, as indicated on service tag. Smoke and carbon monoxide detectors were tested and are operable.

The home is observed to be clean and orderly. The restroom that children use was observed to be safe and sanitary. There are toys available for children located in den and play room. Children have individual cots. Per licensee, there are 8 cots. LPA observed the cots to be in good repair. Licensee states parents provide clean linens, blankets, and pillows, and Licensee washes the linens and blankets every Friday after all children go home.

Currently, children are using the back yard for outdoor play time. The outdoor play area was observed to be fenced. LPA observed that the outdoor yard has toys and other materials for children to play with. LPA did not observe any objects that can pose a danger to children on the outdoor yard. LPA advised there is to be 100% supervision while children are playing in backyard. LPA did not observe bodies of water.

The licensee and other personnel have completed training on preventive health practices including Pediatric CPR and First Aid. The licensee and Licensee's assistant's (adult son) Pediatric CPR and First Aid expires on 7/2023. Licensee's assistant/ daughter's CPR and First Aid expires 2/2022. There are first aid supplies available. Per Licensee, First Aid supplies are stored in a latched cabinet in child's bathroom.

LPA observed that the Licensee and assistants have proof of immunization record and the Mandated Reporter AB 1207 compliant Child Care Training Certificate on file. The Licensee and Licensee's assistants completed the Mandated Reporter training, and expires 3/12/2022.

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

SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-8417
LICENSING EVALUATOR NAME: Alanna GontarekTELEPHONE: (323) 854-8644
LICENSING EVALUATOR SIGNATURE:

DATE: 08/03/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2021
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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: GONZALES FAMILY CHILD CARE
FACILITY NUMBER: 198004496
VISIT DATE: 08/03/2021
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LPA issued a Confidential Names List (LIC 811) to the licensee which documents staff and children’s files reviewed during this inspection.

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 8/1/2021.
Postings: Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted.

LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, or Saucer Chairs. These items are not permitted in a family child care facility. Per licensee, there is a small trampoline located inside licensee's bedroom. Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.

INFANT REQUIREMENTS: Sleeping arrangements for infants (cribs/play yards): LPA did not observe a crib or play yard. LPA advised Licensee that for each infant who is unable to climb out of the crib or play yard, needs to have a crib or play yard, and all equipment needs to meet the US Consumer Product Safety Commission safety standards. LPA advised that cribs and/or play yards need to be free from loose articles and objects, including but not limited to, objects hanging above or attached to the side of the crib. LPA advised that cribs and play yards should not hinder the entrance or exit to and from the space they are sleeping in. LPA advised that mattresses shall be firm and covered with a fitted sheet that is appropriate to the mattress size, and each infant has their individual bedding and is washed weekly as required. Soiled bedding is replaced when wet or soiled and is placed in an area inaccessible to infants. Pacifiers were observed to not be attached to anything. LPA advised that all pacifiers need to be labeled with the child's name. Licensee was advised that infants shall not be swaddled while in care and all infants up to 12 months should be placed on their back for sleeping. LPA advised the licensee to sleep infants where they can always be directly supervised and advised the licensee against sleeping infants in a separate room. Licensee states that infants sleep in the play room. Per Licensee, there is one infant that is almost 2 years old. LPA discussed the following: (1) The provider shall physically check on sleeping infants every 15 minutes. (2) The provider shall document the following: (A) Labored breathing. (B) Signs of distress, which includes but is not limited to flushed skin color, increase in body temperature, and restlessness. (C)Infants up to 12 months of age who are sleeping in a position other than on their back. 1. If the infant’s Individual Infant Sleeping Plan [LIC 9227 (3/20)] does not have Section C completed, the provider shall return the infant to their back for sleeping. Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following: 1. Date. 2. Infant’s name. 3. Time of each 15-minute check. (3) If the provider observes labored breathing or signs of distress as specified in Subsection (j)(2)(B), the provider shall do the following:
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-8417
LICENSING EVALUATOR NAME: Alanna GontarekTELEPHONE: (323) 854-8644
LICENSING EVALUATOR SIGNATURE:

DATE: 08/03/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2021
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: 08/03/2021
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(A) Immediately notify the infant’s authorized representative. (B) Obtain specific instruction from the infant’s authorized representative regarding action to be taken and make prompt arrangements to obtain medical treatment if necessary. (C)There shall be no delay in obtaining emergency medical treatment for the infant if the infant’s condition requires immediate attention. (4) The provider shall be near enough to the sleeping infant to be able to hear them wake up. (5) If the infant is sleeping in a separate room from where the provider is stationed, the door to the room the infant is sleeping in shall remain open at all times. (A) The provider shall be able to visually observe the infant without moving the door. (6) The provider shall be on the same floor as the sleeping infant. (7) A digital video and audio monitoring device may be used in the home but shall not be used in place of the requirements enumerated in Subsection (j). 102423(a)(2) (a) Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. These rights include, but are not limited to, the following: (2) To receive safe, healthful, and comfortable accommodations, furnishings, and equipment. LPA provided the licensee with a copy of the Child Care Provider’s Guide to Safe Sleep, by American Academy of Pediatrics and Helping you to reduce the risk of SIDS. LPA also consulted and explained Child Abuse Reporting, Complaint Hotline information, Never Shake a Baby, and Safe Sleeping practices. Capacity Handout (Small & Large) was provided during this inspection as well.

Incidental Medical Services (IMS):


The licensee states that she does 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.

Exit interview was conducted with Elizabeth Gonzalez. A copy of this report LIC 809, Appeal Rights, and Notice of Site Visit were explained and provided during this visit. 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.
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-8417
LICENSING EVALUATOR NAME: Alanna GontarekTELEPHONE: (323) 854-8644
LICENSING EVALUATOR SIGNATURE:

DATE: 08/03/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2021
LIC809 (FAS) - (06/04)
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