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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 192009044
Report Date: 12/27/2023
Date Signed: 12/27/2023 10:50:50 AM

Document Has Been Signed on 12/27/2023 10:50 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 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: 11CENSUS: 10DATE:
12/27/2023
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Licensee Olivia Gonzalez TIME COMPLETED:
11:00 AM
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On 12/27/23 Licensing Program Analysts (LPAs) Jeanette Estrada and Angelica Wallin conducted an unannounced required 1 year inspection at the above facility. LPAs met with the Licensee Olivia Gonzalez and informed her of the purpose for the visit. Licensee was provided a copy of the Facility Entrance Checklist. There were 10 children and an assistant provider present during the inspection. The facility was in compliance for a large family child care home. All residents were noted and verified. Facility provides care to children ages 0 to 12 years old. The days and hours of operations are Monday through Friday 6:30AM to 5:30PM.
This is a one story, 3 bedroom, 2 bathroom home.
Per Licensee areas on limits to children are: Living room, day care room (master bedroom) to the right of the living room, the bathroom in the day care room and the enclosed backyard.
Per Licensee areas off limits to children are: 2 bedrooms, hallway bathroom, kitchen, gated section of backyard and garage.
All areas that are accessible to children were inspected for safety, comfort, and cleanliness. The following was observed and reviewed during this inspection: LPAs observed required posted documentation- Facility license, Publication (PUB) 394- Notification of Parent Rights and Licensing Form (LIC) 9148- Earthquake Preparedness form. LPAs observed and reviewed a current roster LIC 9040. The last documented drill was conducted on 12/1/23. There is an operable carbon monoxide/ smoke detector in the living room. LPA observed a 2A10BC Fire Extinguisher in the kitchen which indicated full and was last serviced February 2023. The home maintains telephone service. Food is provided by Licensee. Licensee was reminded if children bring food from home it must be labeled with the child’s name and properly stored or refrigerated. There are toys and other age appropriate materials available for children to use in the day care room.
Sharp objects, detergents and cleaning compounds were inaccessible to children in care. Sharp objects and personal medication are kept in the kitchen. LPAs observed the off limits kitchen separated from the living room by a safety gate. Detergents are kept in the laundry room. Cleaning compounds in the on limits restroom are kept in a locked cabinet under the sink. Per Licensee, no children enrolled require medication.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE: DATE: 12/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/27/2023
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: 12/27/2023
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Heating and ventilation was evaluated. The facility has central air and heating. LPAs observed a fireplace in the living room that is inaccessible to children in care. Children nap in the day care room and they are provided appropriate napping equipment.
Children use the backyard for outdoor play. The on limits section of the backyard is fully enclosed. Per Licensee, children are supervised while playing outside. Per Licensee, there are no poisons in the home. Licensee was advised that all poisons must be locked, not only inaccessible to children. Isolation area for sick children waiting to be picked up is in the living room, separated from other children while under adult supervision. Per Licensee, there are no firearms or weapons stored in the home. LPAs did not observe any pools or spas, or other bodies of water. Per Licensee there are no pets in the home. LPAs did not observe any pets.
Children's records were reviewed: Children's records contained (LIC) 282- Affidavit Regarding Liability Insurance, Immunization Records, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights
Staff records were reviewed: Licensee's Red Cross issued Pediatric CPR/First Aid certification was completed on 6/16/23. Licensee's mandated reporter training was completed on 12/14/23. Licensee and assistant's files were complete.
During inspection the children present were observed to be treated with dignity and respect, and were free from corporal and/or unusual punishment.
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 .
Licensee 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.
Currently Licensee does not have infants enrolled. LPA discussed the safe sleep regulations with the 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.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:

DATE: 12/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/27/2023
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: 12/27/2023
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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 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 Center and the ADA, available at: http://www.ada.gov/childqanda.htm
Licensee was informed of the Mychildcareplan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and resource and referral agencies (R&Rs) throughout California.
During the exit interview, the Licensee Olivia Gonzalez, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO in FAS.
A notice of Site Visit was given and must remain posted for 30 days.
Exit interview conducted and report was reviewed with the Licensee, Olivia Gonzalez.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:

DATE: 12/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/27/2023
LIC809 (FAS) - (06/04)
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