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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020211
Report Date: 04/08/2022
Date Signed: 04/08/2022 11:41:18 AM

Document Has Been Signed on 04/08/2022 11:41 AM - 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:AURA GARCIA GORDILLOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 535-5149
CITY:LA PUENTESTATE: CAZIP CODE:
91744
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 10DATE:
04/08/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
10:52 AM
MET WITH:Aura Garcia Gordillo, LicenseeTIME COMPLETED:
11:55 AM
NARRATIVE
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Licensing Program Analyst (LPA) Lissete Gonzalez conducted a Case Management Deficiencies Inspection to address deficiencies observed during visit conducted on 4/08/2022. Licensee, Aura Garcia Gordillo and Licensee's Assistant, Claudia Gasca were present during the inspection.

At 9:15AM on 4/08/2022, during a walk-through of the facility, LPA Gonzalez observed an empty infant bassinet located in the living room area that is accessible to children in care.

At 9:17AM on 4/08/2022, LPA observed the Licensee’s Assistant, Claudia Gasca is not listed on the facility roster. At 9:29AM LPA Gonzalez contacted the Monterey Park Child Care Regional Office and confirmed Claudia Gasca has a criminal record clearance on record, however, Claudia is not associated to this facility.

The following deficiencies on the attached LIC 809 deficiencies page is being cited in accordance with CA code of Regulations Title 22.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with Licensee, Aura Garcia Gordillo.
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Lissete Gonzalez
LICENSING EVALUATOR SIGNATURE: DATE: 04/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/08/2022
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 2
Document Has Been Signed on 04/08/2022 11:41 AM - It Cannot Be Edited


Created By: Lissete Gonzalez On 04/08/2022 at 10:09 AM
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: 04/08/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/11/2022
Section Cited
CCR
87355(e)(1)

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87355 Criminal Record Clearance (e) All individuals subject to criminal record review…shall prior to working … in a licensed facility (1) obtain a California clearance …This requirement is not met as evidenced by: At 9:17AM, LPA L. Gonzalez observed the Licensee’s Assistant, Claudia Gasca, has a criminal record clearance on record,
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Licensee provided LPA with the following forms during inspection: Criminal Record Statement & Out of State Disclosure (LIC 508), Criminal Background Clearance Transfer (LIC 9182) and a copy of Claudia Gasca's I.D. to process association to the facility. LPA will clear deficiency when Claudia is associated to the facility.
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however, Claudia is not associated to this facility. This poses a potential health and safety risk to children in care.
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Type B
04/08/2022
Section Cited
CCR102417(d)

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102417 Operation of a Family Child Care Home (d)The home shall provide safe toys, play equipment and materials. This requirement was not met as evidenced by: At 9:15AM on 4/08/2022, during a walk-through of the facility, LPA Gonzalez observed an empty infant bassinet located in the living room area that is accessible to children in care.
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Licensee states she will remove the bassinet immediately.
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This poses a potential health, safety, and personal rights risk to children in care.
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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:Christina Gabelman
LICENSING EVALUATOR NAME:Lissete Gonzalez
LICENSING EVALUATOR SIGNATURE:
DATE: 04/08/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/08/2022


LIC809 (FAS) - (06/04)
Page: 2 of 2