198004921-5-17-2022-54-CC-RDEO-CEHSSQ-20220517140820

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198004921
Report Date: 05/17/2022
Date Signed: 05/17/2022 02:08:52 PM

Document Has Been Signed on 05/17/2022 02:08 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	GONZALEZ FAMILY CHILD CARE		FACILITY NUMBER:	198004921
ADMINISTRATOR:	GONZALEZ, DORA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(562) 428-6418
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90805
CAPACITY:	14	CENSUS: 9	DATE:	05/17/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Licensee - Dora Gonzalez		TIME COMPLETED:	02:25 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 Analyst (LPA) R. Derraco conducted an unannounced required one year inspection to the above facility on 05/17/22. LPA arrived at the facility at 11:00AM and met with assistant S2 and S3. S2 guided analyst on a tour of the facility. LPA observed Licensee, Dora Gonzalez, arriving at the facility at 11:30 AM. Licensee continued tour with LPA. Per Licensee, there are 14 children that are currently enrolled. There were 9 children present upon arrival. LPA observed S4 arriving at 1:30 PM to have lunch. This is a one-story home which consists of three bedrooms, two bathrooms, kitchen/dining room, living room, car port, front yard and backyard (fenced). The off limit areas include all three bedrooms, and one bathroom. The main care area is located in the living room and the carport. LPA observed required postings on the parent board located at the front door. A certificate of occupancy issued by the City of Long Beach was observed on the parent board which states patio cover built over carport is in compliance with various ordinances. The carport has been converted for day care use. LPA observed age appropriate toys, child sized chairs, child sized tables, cubby lockers, a baby changing station, a wall mounted television, a stand alone freezer, a refrigerator, several art supplies, children reading materials and sleeping cots. Per licensee, naps are taken inside of the living room and sleeping cots are only stored in the carport area designated for care. LPA observed the living room to have two wooden cribs, two pack and plays, two Graco feeding chairs and two motorized infant rockers. LPA observed S3 moving a sleeping child from the infant rocker to the wooden crib. LPA advised licensee, per safe sleep regulations, infants can only sleep in a crib or a play pen. Licensee states that children never sleep in the rocker and they are not plugged in. On occasion the infants use the rocker to sit and watch TV. LPA observed the front yard to have perimeter fencing. Tricycles, plastic outdoor play structures, a swing set, a tetherball pole cemented to a used tire, and additional children's outdoor play equipment were observed in the front yard play area. The backyard play area was also observed to have perimeter fencing. A wooden play structure with a plastic slide was observed in the (page 1 of 3)

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Randy Derraco	TELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:	DATE: 05/17/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/17/2022

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: GONZALEZ FAMILY CHILD CARE	FACILITY NUMBER: 198004921
	VISIT DATE: 05/17/2022

NARRATIVE

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backyard along with additional outdoor play equipment and toys. A child sized table and additional infant feeding chairs were also observed in the backyard play area. LPA observed children in care eating lunch in the backyard play area during inspection. LPA observed the bathroom designated for children in care to be clean and free of defects. Cabinet locks were observed in the bathroom. Per licensee, shampoo, soap and bathroom cleaning supplies are kept locked in the bathroom cabinets. Additional cleaning supplies were observed in the kitchen area beneath the sink. LPA observed the cabinet to be pad locked and also contain a box full of kitchen knives. LPA observed additional cabinets in the kitchen to have a child lock or a pad lock. The licensee states that she provides food for children in care. 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 land line. The valve on the required 2A 10BC fire extinguisher indicates fully charged and was serviced on 02/14/22, as indicated on service tag. Smoke and carbon monoxide detectors were tested and are operable. LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs. No bodies of water were observed on the premises.

Individuals who reside in the home were noted and discussed. Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated. Per Licensee, they currently have two assistants. All adults present in the home have obtained a criminal record clearance or exemption prior to working, residing or volunteering in the licensed childcare home. Licensee states that there are no firearms stored in the home.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee 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.

The licensee and other personnel have completed training on preventive health practices including Pediatric First Aid and CPR. The licensee's Pediatric First Aid and CPR expires on 06/2023. LPA observed that the

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SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Randy Derraco	TELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:	DATE: 05/17/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/17/2022

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: GONZALEZ FAMILY CHILD CARE	FACILITY NUMBER: 198004921
	VISIT DATE: 05/17/2022

NARRATIVE

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Licensee and assistant do have proof of the Mandated Reporter AB 1207 compliant Child Care Training Certificate on file. File review was observed to have proper mandated immunization records. Children’s records were reviewed, including emergency information and were observed to be complete. A current children’s roster was available for review. Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted. Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.

Incidental Medical Services (IMS):
IMS was discussed with licensee. 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 online at: www.cdss.ca.gov. LPA also discussed the Provider Information Notices (PINS) on Recently Approved Safe Sleep Regulations in Effect: PIN 20-24-CCP, Assistant's file checklist, Infant Sleep Chart.

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

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted, appeal rights provided, and report was reviewed with the licensee Dora Gonzalez.

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SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Randy Derraco	TELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:	DATE: 05/17/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/17/2022

LIC809 (FAS) - (06/04)

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