198004921-3-8-2023-54-CC-RDEO-CPQR2E-20230308113814

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198004921
Report Date: 03/08/2023
Date Signed: 03/08/2023 11:38:22 AM

Document Has Been Signed on 03/08/2023 11:38 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK S WEST, 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: 5	DATE:	03/08/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:10 AM
MET WITH:	Assistant - Felicita Escalante		TIME COMPLETED:	12:00 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 1 year annual inspection to the above facility on 03/08/23. LPA arrived at the facility at 9:10 AM and met with Assistant Felicita Escalante, who guided analyst on a tour of the facility. Also present during this inspection was a second assistant, S3. LPA observed licensee arriving to the facility at 10:10 AM and continued tour with LPA. Per Licensee, there are 12 children that are currently enrolled. There were 5 children present upon arrival. 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. LPA observed a leather reclining couch, wall mounted television, 3 wooden cribs, 2 play pens, and 2 infant high chair feeding tables. Parent board was observed next to the entrance of the home to have Emergency Disaster Plan, Parent’s Rights Poster and the Facility License. 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 for the City of Long Beach. Per licensee, she provides food for children in care. The kitchen was observed with locks on all the cabinets and drawers. LPA observed cleaning supplies and sharp objects such as knives, are kept locked beneath the kitchen sink. The carport was observed to be converted to be used as a day care area. LPA observed age appropriate toys, children's art materials, children's reading materials, child sized tables, child sized chairs, children's wooden storage lockers, a wooden baby changing station and educational posters. Licensee confirms that children do not nap or eat in the carport area. Per licensee, naps and meals are taken in the main care area. The bathroom was observed to be clean with an operable sink, toilet and faucet. Outdoor play areas were observed in the front and the back yard. Both areas were observed with perimeter fencing and adequate shade. The front yard play area was observed with children's outdoor play equipment, a swing set with a slide and additional age appropriate toys. The back yard play area was observed with children's (page 1 of 3)

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Randy Derraco	TELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:	DATE: 03/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2023

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
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: GONZALEZ FAMILY CHILD CARE	FACILITY NUMBER: 198004921
	VISIT DATE: 03/08/2023

NARRATIVE

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outdoor play equipment, children's climbing structures and additional age appropriate toys. Per licensee, isolation area for children showing signs of illness will be located in the licensee's bedroom located next to the entrance of the home. LPA observed a sliding glass door that connects the entrance of the bedroom to the entrance of the home. Per licensee, parents are notified immediately for pick up if a child shows signs of illness. LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs. Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.

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. 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 land line. Per Licensee, the home is equipped with central heating and air conditioning. Day care area was observed with safe toys, play equipment and materials. The licensee states that there are no poisons in the home and understands that storage areas for poisons must be locked, not just inaccessible. The valve on the required 2A 10BC fire extinguisher indicates fully charged and was purchased on 02/27/23 as indicated on purchase receipt. Smoke and carbon monoxide detectors were tested and are operable. No bodies of water were observed in the back yard play area. There are no pets on the premises.

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

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SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Randy Derraco	TELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:	DATE: 03/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2023

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
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: GONZALEZ FAMILY CHILD CARE	FACILITY NUMBER: 198004921
	VISIT DATE: 03/08/2023

NARRATIVE

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First Aid and CPR. The licensee's Pediatric First Aid and CPR expires on 06/2023. LPA observed that the Licensee and assistants 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.

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.

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: Karen Chambers	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Randy Derraco	TELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:	DATE: 03/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2023

LIC809 (FAS) - (06/04)

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