198004958-4-27-2023-33-CC-NTCG-CRARYY-20230427132708

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198004958
Report Date: 04/27/2023
Date Signed: 04/27/2023 01:27:19 PM

Document Has Been Signed on 04/27/2023 01:27 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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	GONZALEZ FAMILY CHILD CARE		FACILITY NUMBER:	198004958
ADMINISTRATOR:	GONZALEZ, REYNALDA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(626) 372-0118
CITY:	PASADENA	STATE: CA	ZIP CODE:	91104
CAPACITY:	14	CENSUS: 2	DATE:	04/27/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:07 PM
MET WITH:	Reyna Gonzalez - Licensee		TIME COMPLETED:	01:50 PM

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Licensing Program Analyst (LPA) Nolan Tcheng conducted an unannounced annual random inspection to the above facility. At 12:07pm LPA met with licensee, Reyna Gonzalez. Also present during this inspection, Licensee’s husband. The licensee states that she currently has 4 children enrolled. A current children’s roster is available and is current. Licensee’s hours of operation are 7am-5pm Monday to Friday.

This is a one-story home which consists of 4 bedrooms, 2 bathrooms, day care room, kitchen, dining room, living room, laundry room, converted garage, front yard and backyard (fenced). The children use the living room, dining room, kitchen, laundry room, daycare room, bathroom and backyard. Per licensee, areas off limits to children and parents include: bedrooms and converted garage. All areas identified on the facility sketch were inspected. The licensee provides food for children in care.

The licensee states that 4 adults and 0 children currently live in the home. Licensee states that she currently has one assistant. All individuals present in the home have obtained a criminal record clearance or exemption prior to working, residing or volunteering in a licensed home. Per licensee, there are no weapons, firearms or bodies of water on the premises.

PHYSICAL PLANT

At 12:15pm LPA was lead on a tour of the facility by the licensee. Upon entry, the living room was reviewed. There are age appropriate toys for children in care. The tour continued through the dining room and kitchen. In the dining room, Emergency Disaster Plan, Parent’s Rights Poster and the Facility License are observed to be posted. The kitchen is safe and free of hazards. There are sharp knives kept high on the counter out of reach of children in care. The laundry room next to the kitchen leads to the back yard. Detergents, cleaning compounds, medications, and other items which could pose a danger are inaccessible to children. LPA observed cleaning supplies kept in the laundry room closet out of reach of children in care. The back yard was reviewed. There is a grass area with a small play structure and swings. There are equipment and toys for children in care to use. There are seasonal fruit trees that the licensee states the children enjoy eating.
REPORT CONTINUES PAGE 1 of 3

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) -98-3391
LICENSING EVALUATOR NAME: Nolan Tcheng	TELEPHONE: (323) 240-6201
LICENSING EVALUATOR SIGNATURE:	DATE: 04/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2023

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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: GONZALEZ FAMILY CHILD CARE	FACILITY NUMBER: 198004958
	VISIT DATE: 04/27/2023

NARRATIVE

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The tour continued back inside. At 12:25pm, a fire extinguisher was observed. The valve on the required 2A 10BC fire extinguisher indicates fully charged and was serviced on 03/01/2023, as indicated on service tag. Per State Fire Marshall standards, fire extinguishers shall be serviced annually. LPA observed a closed off fire place in the living room, made inaccessible by a dresser. The tour continued into the back room that is used as baby room and nap area. There wee two play yards and age appropriate toys and equipment. The final room reviewed was the bathroom in the hallway that children in care use. 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. Per licensee, the living will be used as an area for an ill child until an authorized representative comes to pick up child. There are first aid supplies available. Smoke and carbon monoxide detectors were tested and are operable. the licensee states that a cell phone is used and stays at the facility during operating hours. The licensee is observed to be operating within the license capacity limitations.

FACILITY RECORDS:

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 03/2024. Licensee and other personnel have complete mandated reporter training that expires on 12/03/2023. The licensee does have proof of immunization against influenza, tuberculosis, pertussis, and measles. Children’s records were reviewed, including but not limited to, a copy of the emergency information card that contains all the information speciﬁed by regulation.

The following was discussed:

-Individuals who are 18 years of age or older living in the home must be finger print cleared prior to being in the presence of the children in care. Individuals within one month of their 18th birthday must be fingerprinted immediately.
-There is one small dog on the premises. LPA observed dog in the kennel during inspection.
-Infant Walkers, Johnny Jumpers, Saucer Chairs, and/or any other item that falls into these categories are not permitted in a family child care facility.
-Smoking is prohibited in a license family child care home.

LPA advised the licensee how to access forms, regulations and quarterly updates on line at: www.ccld.ca.gov. AB1207 Mandated Child Abuse Reporting – Implementation was discussed with Licensee. Website provided: http://mandatedreporterca.com/

REPORT CONTINUES PAGE 2 of 3

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) -98-3391
LICENSING EVALUATOR NAME: Nolan Tcheng	TELEPHONE: (323) 240-6201
LICENSING EVALUATOR SIGNATURE:	DATE: 04/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2023

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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: GONZALEZ FAMILY CHILD CARE	FACILITY NUMBER: 198004958
	VISIT DATE: 04/27/2023

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Infant Care: Licensee states that they are currently caring for infants. LPA advised the licensee to sleep infants where they can be directly supervised at all times and advised the licensee against sleeping infants in a separate room. Licensee states that infants sleep in the day care room. 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 consulted and explained Child Abuse Reporting, Updated Parent’s Rights Poster with Complaint Hotline information, Never Shake a Baby, Sudden Infant Death Syndrome (SIDS), and Safe Sleeping practices. PIN 20-24-CCP was provided and explained during the inspection.

Incidental Medical Services (IMS):

The licensee states that she will 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.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process

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.

Exit interview was conducted with Licensee Reyna Gonzalez, at 1:30pm. Copy of report provided.

REPORT ENDS PAGE 3 of 3

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) -98-3391
LICENSING EVALUATOR NAME: Nolan Tcheng	TELEPHONE: (323) 240-6201
LICENSING EVALUATOR SIGNATURE:	DATE: 04/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2023

LIC809 (FAS) - (06/04)

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