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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198012194
Report Date: 08/10/2022
Date Signed: 08/10/2022 03:49:37 PM

Document Has Been Signed on 08/10/2022 03:49 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:GALLEGOS FAMILY CHILD CAREFACILITY NUMBER:
198012194
ADMINISTRATOR:GALLEGOS, IRMAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 673-5979
CITY:LONG BEACHSTATE: CAZIP CODE:
90810
CAPACITY: 14TOTAL ENROLLED CHILDREN: 31CENSUS: 12DATE:
08/10/2022
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME BEGAN:
09:50 AM
MET WITH:Irma Gallegos, LicenseeTIME COMPLETED:
04:10 PM
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 THIS INSPECTION WAS CONDUCTED IN SPANISH

On 08/10/2022 at 09:50 am, Licensing Program Analyst (LPA) Susann Sanchez conducted an unannounced annual – continuation from 07/15/2022 inspection at the above facility. LPA met with Manuela Perez, assistant who guided analyst on a tour of the facility. Also present at the facility was Licensee Assistant, Josefina Lopez.

At approximately 10:10am, while touring the facility, LPA and assistants counted 12 children, including 5 infants present when LPA arrived. Facility capacity is not compliance for a large Family Child Care Home.

This is a one story home which consists of 4 bedrooms and 2 bathrooms. Areas used by children include 2 bedrooms, 2 bathrooms, living room with dining area, and backyard. Children only pass through the kitchen to access the back portion of the home. Off limits to children and parents include: 2 bedroom, front yard, and garage.



At 11:20am, Licensee Irma Gallegos arrived and guided LPA on a tour of "off limit" areas at 11:30am. Consult was given at this time until 1:00, regarding visit from 07/15/2022.

The hours of operation are Monday to Friday from 6:00 AM to 6:00PM. Meals and snacks are provided by the Licensee. Licensee was reminded that children who bring food from home must be labeled with the child’s name and properly stored or refrigerated.

Individuals residing in the home have been discussed and noted. All adults present in the home have obtained a criminal record clearance or exemption.

All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. The following was observed and reviewed during this inspection:
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Susann Sanchez
LICENSING EVALUATOR SIGNATURE: DATE: 08/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/10/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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Document Has Been Signed on 08/10/2022 03:49 PM - It Cannot Be Edited


Created By: Susann Sanchez On 08/10/2022 at 01:45 PM
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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: GALLEGOS FAMILY CHILD CARE
FACILITY NUMBER: 198012194

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/10/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Section Cited
Operation of A Family Child Care Home
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Type A
Section Cited
CCR
102416.5(d)(1)
Staffing Ratio and Capacity
(d) For a Large Family Child Care Home, the maximum number of children for whom care may be provided at any one time when there is an assistant provider in the home, including children under age 10 who reside at the licensee's home and the assistant provider's children under age 10, shall be either: (1) Twelve children, no more than four of whom may be infants; or

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above. There was 5 infants present during today's inspection which poses an immediate health and safety risk to persons in care.
POC Due Date: 08/11/2022
Plan of Correction
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Per Licensee, will develop a scattered schedule for (2) infants and will talk to parents tonight 08/10/2022. Per Licensee if she cannot come up with a scattered schedule that works, she will disenroll (2) infants. Licensee will provide a plan to LPA via email and will follow up with LPA via cell phone on 08/11/22.
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:Valarie Cook
LICENSING EVALUATOR NAME:Susann Sanchez
LICENSING EVALUATOR SIGNATURE:
DATE: 08/10/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/10/2022


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Document Has Been Signed on 08/10/2022 03:49 PM - It Cannot Be Edited


Created By: Susann Sanchez On 08/10/2022 at 01:45 PM
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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: GALLEGOS FAMILY CHILD CARE
FACILITY NUMBER: 198012194

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/10/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(1)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (1) Fireplaces and open face heaters shall be screened to prevent access by children. The home shall contain a fire extinguisher and smoke detector device which meet standards established by the State Fire Marshall.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above. The fire extinguisher did not met the 2A10BC standards required by the State Fire Marshall which poses a safety risk to persons in care.
POC Due Date: 08/24/2022
Plan of Correction
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Per Licensee, will purchase 2A10BC by POC due date of 08/24/2022 and submit proof to LPA via email.
Section Cited
Inspection Authority of the Department
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Valarie Cook
LICENSING EVALUATOR NAME:Susann Sanchez
LICENSING EVALUATOR SIGNATURE:
DATE: 08/10/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/10/2022


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Document Has Been Signed on 08/10/2022 03:49 PM - It Cannot Be Edited


Created By: Susann Sanchez On 08/10/2022 at 01:45 PM
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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: GALLEGOS FAMILY CHILD CARE
FACILITY NUMBER: 198012194

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/10/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102421(a)(1)
Child's Records
(a) The licensee shall maintain, in each child's record, the signed and dated notice form required in Section 102419(d). (1) The licensee shall keep the signed and dated notice form for at least three years following
termination of service to the child.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and record review, the licensee did not comply with the section cited above. On 07/15/22, assistants were not able to locate any files which poses a potential safety risk to persons in care.
POC Due Date: 08/10/2022
Plan of Correction
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The observation were corrected and not observed during today's inspection. During today's inspection, all children's files were current and up to date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Valarie Cook
LICENSING EVALUATOR NAME:Susann Sanchez
LICENSING EVALUATOR SIGNATURE:
DATE: 08/10/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/10/2022


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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: GALLEGOS FAMILY CHILD CARE
FACILITY NUMBER: 198012194
VISIT DATE: 08/10/2022
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LPA observed the following documents posted Facility License, Notification of Parents' Rights (PUB 394), Earthquake Preparedness (LIC 9148), Emergency Disaster Plan (LIC 610A), and Facility Roster (LIC 9040). Disaster and Fire Drill was last conducted on 03/25/2022.

Smoke and carbon monoxide detectors were tested and are operable. The home maintains telephone service via cell phone. The home is observed to be clean and orderly. There are toys and other age appropriate material available for children. LPA's observed that detergents, cleaning compounds and medication are stored in the high cabinet in the laundry room, inaccessible to children. Licensee states that there are no poisons stored in the home and understands that all poisons must be locked and inaccessible to children. Isolation area for sick children waiting to be picked up is in the living room, away from the other children. Per Licensee there are no firearms or weapons present in the home.

At approximately 11:30am, LPA observe a fire extinguisher in the kitchen, but it was not the required 2A10BC. Licensee stated that was the only fire extinguisher at the facility.

Currently, children are using the backyard for outdoor play. The outdoor play area was observed to be fenced. . LPA observed that the outdoor yard has toys and other materials for children to play with. LPA did not observe any objects that could be hazardous to children in care. There are no pools or spas, or other bodies of water.

Infant Care: Currently licensee has 6 infants enroll and 5 infant was present during inspection. LPA observed 4 play yards, 3 were located in the bedroom and 1 was located in the living room . Per Licensee other infants sleep on a cotst. Napping equipment does not block entrances or exits. Infant mattresses were observed to be firm with tightly fitted sheets. LPA did not observe loose object, bumpers, objects hanging, or objects attached to the play yards. LPA informed licensee of the new Safe sleep regulations, including LIC 9227 Infant Sleep Plan for infants under 12 months, 15-minute sleep check documentation for infants 0-24 months, and provided PIN 20-24-CCP on 07/15/22. Licensee states the following a sleep supervision plan for infants: to continue sleeping children in the bedroom room.

Safe sleep, Infant sleeping plan, and 15-minute log was also discussed on 07/15/2022, technical violations were given.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Susann Sanchez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/10/2022
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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: GALLEGOS FAMILY CHILD CARE
FACILITY NUMBER: 198012194
VISIT DATE: 08/10/2022
NARRATIVE
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Children’s records were reviewed for Affidavit Regarding Liability Insurance (LIC 282), Immunization Records, Identification and Emergency Information (LIC 700), Consent for Emergency Medical Treatment (LIC 627), and Notification of Parents’ Rights (LIC 995A). LPA conducted a personnel record review for the following documents: Criminal Record Statement (LIC 508), Employee Rights (LIC 9052), Statement Acknowledging Requirement to Report Child Abuse (LIC 9108), Pediatric CPR/First Aid (expires: 07/20/2024), TB clearance and proof of immunization records for measles (MMR), pertussis (Tdap), and Influenza.

LPA gave a Technical Violation during today's inspection for Mandated Reporter. Licensee stated she was not aware of the training now being offered in Spanish. LPA provided information during inspection on how to maintain training.

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

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.LPA discussed the safe sleep regulations with licensee [or facility representative] 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: Susann Sanchez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/10/2022
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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: GALLEGOS FAMILY CHILD CARE
FACILITY NUMBER: 198012194
VISIT DATE: 08/10/2022
NARRATIVE
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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.

On 07/15/2022, the following was observed and citations will be cited during todays visit:
  • Roster & Records- was not available and assistants stated they did not have any contact information. Based on today's observation 08/10/22 items were corrected and not observed during today's inspection.

Technical Violations and Advisories were given from the inspection conducted on 07/15/2022:
  • Children Records- was not available during inspection.
  • Licensee not present
  • Broken window- the observation were corrected and not observed during today's inspection.


Based on the LPA’s observations and records review, the following deficiencies listed on the attached LIC 809D (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.

A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled children for the next 12 months (1 year). The Acknowledgement form must be maintained in each child’s file immediately upon receipt from parent. Licensee was provided with a copy of the parent Acknowledgement of Receipt of Licensing Reports Form during this visit.

A notice of site visit was given and must remain posted for 30 days. An exit interview was conducted and the report was reviewed with the Licensee, Irma Gallegos. Appeal Rights were given in Spanish and explained.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Susann Sanchez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/10/2022
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