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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020211
Report Date: 10/25/2024
Date Signed: 10/26/2024 03:45:14 PM

Document Has Been Signed on 10/26/2024 03:45 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:GARCIA GORDILLO FAMILY CHILD CAREFACILITY NUMBER:
198020211
ADMINISTRATOR/
DIRECTOR:		AURA GARCIA GORDILLOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 535-5149
CITY:LA PUENTESTATE: CAZIP CODE:
91744
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 10DATE:
10/25/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:40 PM
MET WITH:Aura Garcia GordilloTIME VISIT/
INSPECTION COMPLETED:
06:30 PM
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On 10/25/2024 at 2:40 pm, Licensing Program Analyst (LPA), Carolyn Tuba conducted an unannounced inspection visit for the above facility. Covid risk assessment was conducted. LPA entered home through the front door. The facility is a large family childcare. LPA met with assistant, Milagro Portillo. Licensee arrived shortly after at approximately 3:00 pm. LPA observed the assistant alone with 10 children, while Licensee had left to run an errand.

License stated that she currently has 12 children enrolled at this time. LPA discussed the Resource and Referral program through Pomona Unified that can assist and refer families to the daycare. LPA also consulted about leaving the assistant alone with more then 8 children in care.

Family members residing in the home are 2 adults (criminal record clearances on file) and 4 children. This is a one-story home which consists of 3 bedrooms, 2 bathrooms, living room, dining area, kitchen, garage, and a side yard enclosed, backyard enclosed with cement wall and a side dog run.

A facility roster was available. Per Licensee, operating hours are from Monday-Friday 7:00 am – 6:00 pm and cares for children ages 3 months to 13 years of age.

Licensee states that all meals are provided by the facility, and they currently use a food program. Meals offered are Breakfast, Lunch and PM snack. Formula and baby food is provided by parents and items must be labeled with child’s name and stored appropriately.

Areas used by children were inspected include: Living room set up as a daycare, 1 bathroom near the front entrance, dining area and enclosed back yard and side yard located near the front of the home which is also enclosed.
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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Carolyn Tuba
LICENSING EVALUATOR SIGNATURE: DATE: 10/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/25/2024
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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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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: GARCIA GORDILLO FAMILY CHILD CARE
FACILITY NUMBER: 198020211
VISIT DATE: 10/25/2024
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Per Licensee areas off limits include: 3 bedrooms, 1 master bathroom, kitchen, dog run, garage, front area of the home are kept off-limits and need to be made inaccessible during operating hours. There is a play structure but according to the licensee is off-limits to children in care and is separated by an enclosed gate.

LPA did not observe bodies of water at the property. Should a pool, spa, fountain or pond be installed Licensee is encouraged to contact the Department for regulations.

Licensee states there is no firearm stored in the home. The home was inspected for safety, comfort, cleanliness, ventilation, and telephone service. LPA verified the phone number and email address which was found to be correct. Fire and safety drills must be performed every 6 months and documented for review by the Department. Licensee conducted an Emergency Drill on September 2024. No one smokes at the family childcare home. Parent Board was available with all required forms.

In the absence of the licensee a qualified adult must be present supervising the children; a qualified adult is an individual who has a valid and current Pediatric First Aid and CPR training EMSA approved, Immunization's (TDAP, MMR, TB, Influenza (or a waiver for the influenza may be in writing), mandated reporter training and a valid criminal record clearance associated to the facility license.

Detergents, cleaning compounds, medications, and other items, which could pose a danger, were determined to be inaccessible to children in care during this inspection. Knives are kept on a high shelf out of reach of children. Medications/vitamins are kept inaccessible to children in care. Cleaning supplies are kept under the kitchen sink inaccessible to children in care.

LPA observed the required 2:A-10:B-C fire extinguisher, which was last serviced April 10, 2024. State Fire Marshall standards, state that fire extinguisher shall be purchased or serviced annually. The smoke and carbon monoxide detector was tested and operating properly during the visit. Currently the facility has (2) Dogs a Chihuahua mix and a Pug mix and are kepted in the dog run away from the children in care.

Licensee cares for children 24 months and younger, and safe sleep was discussed and LPA advised of
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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Carolyn Tuba
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2024
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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: GARCIA GORDILLO FAMILY CHILD CARE
FACILITY NUMBER: 198020211
VISIT DATE: 10/25/2024
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PIN 20-24 CCP Safe Sleep. LPA observed the 15-minute safe sleep log for children under 24 months and discussed Individualized Infant Safe Sleep Plan for children under 12 months. LPA observed an Infant Safe Sleep Plan in child’s file.

The licensee has completed training on preventive health practices. Pediatric First Aid and CPR, which includes the EMSA Sticker was available, which expires on 5/6/2025. There are first aid supplies available. Licensee’s Mandated Reporting Training Certificate expired 4/2024 and the assistant’s expired 9/2024. LPA advised that all persons working with children require the AB 1207 Mandated Reporting training which needs to be completed every 2 years. The following link http://www.mandatedreporterca.com/ was provided.

The back yard which has plenty toys, bikes, play equipment and shade for the children, as well as the side yard is available for the children to play outside with a tree and rope swings. All enclosed with a gate and cement walls.

Children and staff files must be maintained and updated as needed and must be available for review by the Department. If Children and staff leave the day care all records must be maintained for 3 years after leaving. LPA observed that children’s files were complete. LPA advised that the following documents of the LIC 700, LIC 627 and LIC 995A are required, as well as the immunizations. LIC 282 is also needed if liability insurance is not available.

Licensee provided an updated LIC279B for minors living in the home, and an updated facility sketch.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Page 3 of 5
SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Carolyn Tuba
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2024
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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: GARCIA GORDILLO FAMILY CHILD CARE
FACILITY NUMBER: 198020211
VISIT DATE: 10/25/2024
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Family Childcare Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated. LPAs reviewed clearance list and will be removing persons that no longer live or work in the home.

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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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: https://www.ada.gov/resources/child-care-centers/. There are no children currently taking medication.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, the Licensee, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

The deficiency listed on the following page were observed by the LPA and is being cited in accordance with California Code of Regulations Title 22. Please see attached LIC 809-D. The deficiency that is being cited needs to be cleared to protect the children’s health & safety.
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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Carolyn Tuba
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2024
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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: GARCIA GORDILLO FAMILY CHILD CARE
FACILITY NUMBER: 198020211
VISIT DATE: 10/25/2024
NARRATIVE
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Type A - A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled children for the next 12 months (1 year). The Acknowledgement form must be maintained in each child’s file immediately upon receipt from parent. Licensee was provided with a copy of the parent Acknowledgement of Receipt of Licensing Reports Form (LIC 9224) during this visit.

A notice of site visit was given and must remain posted for 30 days. An exit interview was conducted, and report was reviewed with the Licensee, Aura Garcia Gordillo.
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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Carolyn Tuba
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/26/2024 03:45 PM - It Cannot Be Edited


Created By: Carolyn Tuba On 10/25/2024 at 05:32 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: GARCIA GORDILLO FAMILY CHILD CARE
FACILITY NUMBER: 198020211

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/25/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102416.5(e)
Staffing Ratio and Capacity
(e) If no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home as specified in subsections (b) and (c).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in 10 children were found alone with the assisatnt, as licensee was out running an errand which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 10/25/2024
Plan of Correction
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LPA consulted with the Licensee if she needs to to step out of the home no more then 20% of the operating hours, then the Assistant needs to be operating as a small child care.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Ana Chico
LICENSING EVALUATOR NAME:Carolyn Tuba
LICENSING EVALUATOR SIGNATURE:
DATE: 10/25/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/25/2024


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/26/2024 03:45 PM - It Cannot Be Edited


Created By: Carolyn Tuba On 10/25/2024 at 05:32 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: GARCIA GORDILLO FAMILY CHILD CARE
FACILITY NUMBER: 198020211

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/25/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in licensee and the assistant's mandated reporting training expired and needs to be renewed which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/04/2024
Plan of Correction
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Licensee and assistant will renew the Mandated Reporter Training and LPA will obtain a proof of completion.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Ana Chico
LICENSING EVALUATOR NAME:Carolyn Tuba
LICENSING EVALUATOR SIGNATURE:
DATE: 10/25/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/25/2024


LIC809 (FAS) - (06/04)
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