198016431-2-28-2022-54-CC-ECHZ-CC3TH4-20220228134407

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198016431
Report Date: 02/28/2022
Date Signed: 02/28/2022 01:44:26 PM

Document Has Been Signed on 02/28/2022 01:44 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:	GUTIERREZ FAMILY CHILD CARE		FACILITY NUMBER:	198016431
ADMINISTRATOR:	GUTIERREZ, MARIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(562) 639-4548
CITY:	BELLFLOWER	STATE: CA	ZIP CODE:	90706
CAPACITY:	14	CENSUS: 0	DATE:	02/28/2022
TYPE OF VISIT:	Office	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Maria Gutierrez		TIME COMPLETED:	11:30 AM

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	A virtual Informal Office meeting was conducted on this date with Licensee, Maria Gutierrez. In attendance are Licensing Program Analyst (LPA) Elka Chavez, Licensing Program Analyst (LPA) Monique Ayala and Licensing Program Manager (LPM) Karen Chambers. During this meeting Spanish interpreting was provided by LPA Elka Chavez The purpose of the informal meeting is to discuss supervision of the children while in care, especially while outside. During this meeting the events surrounding a child who wandered away were discussed. The Licensee noted that since the incident of June 24 2021, the children play in the back yard and not the front and the maximum number of children in care is five. The Licensee has installed a camera as well as a door alarm (tested during virtual meeting) so that she’s made aware if a child should happen to open the door. The licensee has been advised that she will need to test the alarm weekly and log the results. This log shall be kept and made available to Department staff upon request. The Licensee shall also count the children prior to going outside as well as prior to going back inside. These counts shall be daily and logged as well. This log shall include the time of each count and too shall be made available to Department staff upon request. According to the Licensee, should she have to go inside to take a child to the restroom her assistant shall remain outside with the children.

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Elka Chavez	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 02/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2022

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: GUTIERREZ FAMILY CHILD CARE	FACILITY NUMBER: 198016431
	VISIT DATE: 02/28/2022

NARRATIVE

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TSP services were explained to the Licensee and a referral shall be made. Licensee was advised that the facility shall be placed on increased monitoring for the next 18 months.

A copy of Title 22 Regulations with regards to 102417 Operation of a Family Child Care Home were provided to Licensee, Maria Gutierrez. In addition, the licensee was provided with the email for Incident Reports MPSWIncidentReports@dss.ca.gov.

Exit interview conducted with Maria Gutierrez, who is in agreement with the above. A copy of this report shall be emailed to the Licensee for signing and returned to the Department. Appeal rights were explained and will be mailed with the signed copy of this report provided.

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Elka Chavez	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 02/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2022

LIC809 (FAS) - (06/04)

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