<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198006296
Report Date: 11/16/2021
Date Signed: 11/16/2021 04:08:58 PM

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:MURILLO FAMILY CHILD CAREFACILITY NUMBER:
198006296
ADMINISTRATOR:MURILLO, GABRIELAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 961-3998
CITY:LONG BEACHSTATE: CAZIP CODE:
90815
CAPACITY:14CENSUS: 9DATE:
11/16/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:18 PM
MET WITH:Gabriela MurilloTIME COMPLETED:
04:20 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) Warren Birks conducted an unannounced Case Management inspection. This inspection is for the purpose of clearing deficiencies from a previous November 11, 2021 inspection. Upon arrival LPA met with Licensee Gabriella Murillo who along with her assistant was providing care for nine children (3 infants, 5 preschool and one school age).

LPA observed the following numbered items to be cleared:

1. All adult children have been fingerprint cleared.
2. LPA observed November 13, 2021 fire extinguisher service receipt.
3. LPA observed disaster drill conducted.
4. Disaster plan updated and posted.

Open items: CPR class is being scheduled; Staff Immunization records are being retrieved; Child immunization records are still being retrieved

Note: LPA reminded Licensee of possible capacity and ratio scenarios approved under Title 22. LPA also reminded Licensee of the following:

Exit interview was conducted with Licensee Murillo. The Licensee was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these forms. 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.
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Warren BirksTELEPHONE: 323-981-3373
LICENSING EVALUATOR SIGNATURE:

DATE: 11/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/16/2021
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 1