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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197495743
Report Date: 06/24/2026
Date Signed: 06/24/2026 01:49:55 PM

Document Has Been Signed on 06/24/2026 01:49 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
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:GUTIERREZ FAMILY CHILD CAREFACILITY NUMBER:
197495743
ADMINISTRATOR/
DIRECTOR:
LISSET GUTIERREZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 774-9979
CITY:HAWTHRORNESTATE: CAZIP CODE:
90250
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
06/24/2026
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:00 AM
MET WITH:Lisset GutierrezTIME VISIT/
INSPECTION COMPLETED:
02:00 PM
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On 6/24/2026 Licensing Program Analysts (LPAs) Patsy Plancarte and Doris Whitmore conducted an announced inspection with applicant Lisset Gutierrez for a relocation visit. The purpose of this inspection is to ensure the standards for a Family Child Care Home are being met in accordance with California Tittle 22 Regulations and California Health and Safety Codes.

The applicant is applying for a relocation License of a large Family Child Care Home license for a max capacity of 14. Applicant confirmed, living in the home is applicant, applicant's husband, and 3 minor children. Present during today’s inspection was applicant, applicant’s Husband and 3 minor children.

Per the application, currently, the ages the applicant wishes to provide services for, are children ages 24 months- 5 yrs. Hours of operation are 7:45 am- 5:30pm, 5 days a week. Applicant was informed that any changes to ages, hours and days of operation shall be submitted to the department via LIC 279 approval prior to the initiation of changes.

LPAs toured the home inside and outside. This home is a single-family home with 5 bedrooms, Living room 3 bathrooms, dining room, kitchen, family room laundry room, attached garage, front and back yard. Per applicant Living room, Primary bedroom, bathroom, bonus bedroom, Front bedroom, Bedroom near kitchen (Classroom 1) are OFF-LIMITS. Doors will remain locked/closed during business hours. Primary care will be provided in the family room. Parents will access the home through the side gate with a camera, motion doorbell and walk children through the corridor. LPA’s observed all necessary postings. LPAs observed children’s cubbies outside the side entrance gate.

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NAME OF LICENSING PROGRAM MANAGER: Karren Starks
NAME OF LICENSING PROGRAM ANALYST: Patsy Plancarte
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/24/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/24/2026
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 5
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: GUTIERREZ FAMILY CHILD CARE
FACILITY NUMBER: 197495743
VISIT DATE: 06/24/2026
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Primary space (family room) was observed with a variety of children’s books, puzzles and table for activities. In primary care area there is 2 doors that lead to the back yard space. Per applicant the 2 doors will only be opened when the children go outside. LPAs observed the 2 doors were locked and currently functioning. LPAs observed in classroom 2 a glass sliding door, LPA’s reminded applicant to always use 100% supervision of children. Classroom 2 has 1 changing mat, 4 playpens, foldable cots were observed in the space and activities for children. The applicant confirmed children will eat in the primary care area and back yard space, children will nap in the primary care area and classroom 1. LPAs observed a working smoke detector, carbon monoxide combo and working 2A-10-BC fire extinguisher mounted in the primary care area. LPAs observed a fully stocked First aid kit in the home.

The back yard space was observed leading to stairs into the yard has play structure, an Infant outside wooden pen, games and toys for children.

Bathroom 2. Sink, toilet and bathtub were observed and inspected. All bathroom cabinets were observed with safety latches, making the content inaccessible to the children in care. LPAs reminded applicant that all toiletries in bathroom will need to remain inaccessible to children in care during the hours of operation. LPAs observed laundry room next to kitchen (primary care area). The single home has central air for both heater and air conditioning.

The kitchen was observed and inspected and will be, OFF-LIMITS inaccessible to the children in care. Refrigerator, stove and counter space were observed and inspected. Knives stored in top drawer, Chemicals locked above cabinet and stored away in the top cabinet of the laundry area The applicant confirmed home will provide meals and snacks. LPAs discussed the importance of having policies in place to ensure that all who help with care and supervision are aware of any dietary restrictions and/or allergies. LPAs also encouraged applicant to contact their local Resource and Referral agency, Connections for Children, to inquire about any food programs and/or other professional development opportunities and resources. Per applicant there is a firearm and ammunition on the property LPAs took pictures of the firearm and ammunition. Both items were stored separately in the home. Regulation 102417 (4)(a)(b). LPAs discussed the regulation with applicant.

Per applicant there are no bodies of water on the property. applicant informed LPAs there are also no bodies of water nearby neighbors.

No pets on the property.

NAME OF LICENSING PROGRAM MANAGER: Karren Starks
NAME OF LICENSING PROGRAM ANALYST: Patsy Plancarte
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/24/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2026
LIC809 (FAS) - (06/04)
Page: 3 of 5
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: GUTIERREZ FAMILY CHILD CARE
FACILITY NUMBER: 197495743
VISIT DATE: 06/24/2026
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The following areas are OFF LIMITS to the children in care:

Primary Bedroom, bathroom 1, Bonus bedroom, front bedroom, living room, attached garage and classroom 1

The following corrections will need to be completed by 7/10/26.

· Applicant will send pictures to inspector for gate parents use to enter

Applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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 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.

The applicant provided proof of control of property.

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) or (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.

LPAs reviewed with applicant the LIC 311D, Forms/Records to Keep in your Family Child Care Home, children’s forms/records, facility forms/records, and information to be posted. Entrance Checklist was provided to the applicant.

LPA discussed the safe sleep regulations with applicant 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 applicant of the importance of checking for and removing 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.

NAME OF LICENSING PROGRAM MANAGER: Karren Starks
NAME OF LICENSING PROGRAM ANALYST: Patsy Plancarte
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/24/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2026
LIC809 (FAS) - (06/04)
Page: 4 of 5
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: GUTIERREZ FAMILY CHILD CARE
FACILITY NUMBER: 197495743
VISIT DATE: 06/24/2026
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On this date, 04/21/2026, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility address. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

Applicant or was informed of the MyChildCarePlan.org site, 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.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters, and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/communitycare-licensing/subscribe and select the Child Care option to receive email communication.

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

Exit interview conducted and report was reviewed with the applicant.

NAME OF LICENSING PROGRAM MANAGER: Karren Starks
NAME OF LICENSING PROGRAM ANALYST: Patsy Plancarte
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/24/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2026
LIC809 (FAS) - (06/04)
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