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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019135
Report Date: 01/02/2024
Date Signed: 01/02/2024 03:44:34 PM


Document Has Been Signed on 01/02/2024 03:44 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754



FACILITY NAME:GONZALEZ FAMILY CHILD CAREFACILITY NUMBER:
198019135
ADMINISTRATOR:GONZALEZ, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 974-5772
CITY:LOS ANGELESSTATE: CAZIP CODE:
90032
CAPACITY:14CENSUS: DATE:
01/02/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Maria Gonzalez, LicenseeTIME COMPLETED:
04:00 PM
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On 1/2/2024, Licensing Program Analyst (LPA), Staicy conducted an unannounced POC (plan of correction) inspection to ensure the one (1) -Type A deficiencies cited on 12/18/2023 and l (3) Type B deficiencies cited on 12/18/2023 have been cleared. A COVID risk assessment was conducted upon entry. LPA met with Licensee, Maria Gonzalez, who guided LPA on a census of 3 children Licensee and Licensees assistant in care at 2:00pm. The purpose of this inspection is to ensure that the facility is in compliance with Title 22 Regulations and the deficiencies cited on 12/18/23 were corrected.

Licensing staff observed and reviewed the following:
1. Medications have been removed and stored in a locked cabinet inaccessible to the children.
2. Infant Saucer has been removed / discarded from facility
3. Infant Cribs have been free of all loose articles and objects.
4. Review 3 out of 4 children's records for immunization records.

LPA cleared the above deficiencies on this date and provided a copy of issued POC clearance letter during the visit. At this time, the facility is in compliance with California Code of Regulations Title 22. Therefore, no deficiencies are being cited.

A notice of site visit was given to Director and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.



Exit interview conducted and report was reviewed with the Licensee Maria Gonzalez.
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Staicy PerryTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 01/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/02/2024
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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