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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 192009044
Report Date: 11/17/2021
Date Signed: 11/17/2021 05:21:55 PM

Document Has Been Signed on 11/17/2021 05:21 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:GONZALEZ FAMILY CHILD CAREFACILITY NUMBER:
192009044
ADMINISTRATOR:GONZALEZ, OLIVIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 406-1032
CITY:NORWALKSTATE: CAZIP CODE:
90650
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 2DATE:
11/17/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Olivia Gonzalez, LicenseeTIME COMPLETED:
02:40 PM
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Prior to entrance to the facility, LPA Lucero conducted a Covid-19 assessment and based on the licensee responses to the facility assessment questions, LPA Lucero determined it was safe to proceed. On Wednesday, November 17, 2021 at 12:35pm, Licensing Program Analyst (LPA) Lucero conducted an unannounced Required One Year Inspection. LPA met with Licensee Olivia Gonzalez who guided LPA on an indoor and outdoor tour of the facility. There were two children present at the time of inspection and LPA observed Licensee's assistant in the home at time of inspection caring for children. Family members residing in the home has been discussed with licensee and are cleared.

This facility is a one-story home that consists of three bedrooms, two bathrooms, kitchen, living room, dining area, family room, attached garage, front and backyard. Per licensee, areas accessible to children and identified on the facility sketch were inspected by LPA which consists of living room, one bedroom dedicated for the purpose of day care, one bathroom located in day care area, and back yard. Per Licensee, areas off-limits to children and identified on the facility sketch are attached garage, kitchen, dining area, two bedrooms located near kitchen, one bathroom in hallway, family room, and front yard.

At approximately 12:40pm, LPA began the facility to inspect for safety, comfort, cleanliness, ventilation and working phone. For ventilation, LPA observed that the facility has central air and heating. LPA observed a fireplace in the living room with a screen. LPA observed the furniture and children materials to be in good condition and age appropriate. LPA observed the Children Roster, LIC 610A Emergency Disaster Plan, PUB 394 Parent’s Rights, emergency drills posted on the Parent Board in day care area.

At approximately 12:45pm, LPA entered the restroom and observed the toilet, hand washing sink, running water, towel, and hand soap. LPA observed the bottom cabinets closed and with a child proof lock in place making it inaccessible to children to open cabinet doors. LPA observed the restroom to be in good condition.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Armando J Lucero
LICENSING EVALUATOR SIGNATURE: DATE: 11/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/17/2021
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: GONZALEZ FAMILY CHILD CARE
FACILITY NUMBER: 192009044
VISIT DATE: 11/17/2021
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At approximately 12:50pm, LPA observed the off-limits kitchen with a fence at the doorway to prevent children from gaining access.

LPA asked if there are any pets, poisons, firearms, weapons or bodies of water. Licensee stated she does not have any pets, and no body of waters, firearms, weapons or poisons. LPA did not observe bodies of water on the premises. Licensee was advised that if any poisons (ex: Drano, rat poison or items with skull hazard symbol), firearms and weapons are purchased, it is required to be locked with a key or combination lock and firearm and ammunition must be stored separately.



At approximately 12:52pm, LPA observed the required 2A10BC fire extinguisher located in the kitchen and the valve on the green area indicating fully charged and LPA observed a service tag indicating service was conducted in March 2021. LPA observed the smoke detector and carbon monoxide detector (dual) in the day care area. Licensee's assistant tested detectors until a beeping sound emanated from the device. The smoke and carbon detector (dual) appear to be in good an operable condition. At approximately 12:55pm, LPA inspected the outdoor area used by children for safety, comfort and cleanliness. LPA observed play equipment to be in good condition and age appropriate.

At approximately 1:15pm, LPA conducted a records review. LPA observed licensee’s Pediatric First Aid/ CPR card issued by American Red Cross with completed date of 06/08/21. Discussion was held with Licensee regarding the importance of maintaining current Pediatric CPR/First Aid certification. Licensee was advised that the mandated reporter training must be completed every 2 years, and is available at www.mandatedreporterca.com and is also available in Spanish.

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 Olivia Gonzalez of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at also explained to licensee that car seat, stroller are only and only for https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Armando J Lucero
LICENSING EVALUATOR SIGNATURE:

DATE: 11/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2021
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: GONZALEZ FAMILY CHILD CARE
FACILITY NUMBER: 192009044
VISIT DATE: 11/17/2021
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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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: http://www.ada.gov/childqanda.htm

Licensee Olivia Gonzalez was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process

A notice of site visit was given and must remain posted for 30 days. No deficiencies cited. Exit interview conducted and report was reviewed with the licensee Olivia Gonzalez.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Armando J Lucero
LICENSING EVALUATOR SIGNATURE:

DATE: 11/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2021
LIC809 (FAS) - (06/04)
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