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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197417598
Report Date: 05/13/2026
Date Signed: 05/13/2026 11:21:26 AM

Document Has Been Signed on 05/13/2026 11:21 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
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:GOMEZ FAMILY CHILD CAREFACILITY NUMBER:
197417598
ADMINISTRATOR/
DIRECTOR:		GOMEZ, BEATRIZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 834-0654
CITY:WILMINGTONSTATE: CAZIP CODE:
90744
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
05/13/2026
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:20 AM
MET WITH:Beatriz Gomez - LicenseeTIME VISIT/
INSPECTION COMPLETED:
11:10 AM
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On 05/13/2026, Licensing Program Analyst (LPA) Cristina Castellanos conducted an unannounced 3-Year Required Inspection at the above-referenced Family Child Care Home. LPA was greeted by Licensee Beatriz Gomez, who granted entry. Present during the inspection were the Licensee and the licensee’s medium-built pet dog; no children in care were present.

The purpose of this inspection is to ensure continued compliance with the health, safety, and personal rights requirements outlined in Title 22 Regulations governing California Family Child Care Homes. The facility is licensed as a Large Family Child Care Home with a maximum capacity of 14 children. The program currently serves children ages 2 to 13 years and operates Monday through Friday, 7:00 a.m. to 6:00 p.m. The Licensee does not provide overnight or weekend care.

Capacity as specified on the license was observed to be in compliance. The single-family home includes a living room, kitchen/dining area, two bedrooms, one bathroom, a detached laundry room, and a detached garage. The detached garage has been converted into an outdoor activity space for children.

Licensee Gomez identified the following areas as OFF LIMITS to children:


§ Bedrooms 1 and 2
§ Detached laundry area
§ Dog’s designated outdoor area
The medium built pet dog is kept away from children during operating hours. LPA reminded the Licensee that all off-limits areas must remain inaccessible while children are present.

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NAME OF LICENSING PROGRAM MANAGER: Loyce Phillips
NAME OF LICENSING PROGRAM ANALYST: Cristina Castellanos
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/13/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/13/2026
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: GOMEZ FAMILY CHILD CARE
FACILITY NUMBER: 197417598
VISIT DATE: 05/13/2026
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Families enter through the main entrance and proceed directly into the living space. The living room, kitchen/dining area, and converted garage serve as the designated child-care areas. The living room is used for napping; the dining area is used for meals.

The open-faced heater in the living room was properly barricaded. Adequate heating and ventilation were observed throughout the licensed areas. Age-appropriate toys and equipment were available and in good condition. The home maintains a working telephone.

Licensee Gomez provides meals and snacks. LPA discussed the importance of maintaining clear communication regarding dietary restrictions and allergies for all individuals assisting with care.

No firearms or ammunition are stored on the premises. Detergents and cleaning compounds are stored under the kitchen sink in a cabinet secured with a safety latch. Additional cleaning supplies are stored in the laundry area, out of children’s reach.

Two working fire extinguishers were observed in the kitchen. A functioning dual carbon monoxide detector and smoke alarm were observed in the living room. LPA reminded the Licensee that fire and disaster drills must be conducted every six months, documented with date and time, and kept on site.

The Licensee stated the home is prepared to accept a child requiring medication, though no current children require medication. The Licensee ensures children are supervised at all times and understands that children must never be left in parked vehicles. Car seats are used only for transportation, not for sleeping.

LPA reviewed one personnel file and confirmed compliance with Pediatric CPR/First Aid and Mandated Reporter Training requirements. LPA reminded the Licensee that all Pediatric CPR/First Aid vendors must be EMSA-approved.

Six children’s files were reviewed and found complete. Updated copies of the LIC 311D and LIC 126 were provided for future file audits.

Family Child Care Home 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

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NAME OF LICENSING PROGRAM MANAGER: Loyce Phillips
NAME OF LICENSING PROGRAM ANALYST: Cristina Castellanos
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/13/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2026
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
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: GOMEZ FAMILY CHILD CARE
FACILITY NUMBER: 197417598
VISIT DATE: 05/13/2026
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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 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.

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-andresources/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/.

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.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, there were no deficiencies cited at this time.

An exit interview was conducted and reviewed with Licensee Beatriz Gomez. A copy of this report was discussed and left with Licensee. A Notice of Site Visit was given and must remain posted for 30 days. Failure to comply with the posting requirements shall result in an immediate civil penalty of $100.


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NAME OF LICENSING PROGRAM MANAGER: Loyce Phillips
NAME OF LICENSING PROGRAM ANALYST: Cristina Castellanos
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/13/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2026
LIC809 (FAS) - (06/04)
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