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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198016194
Report Date: 06/22/2023
Date Signed: 06/22/2023 11:41:42 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/13/2023 and conducted by Evaluator Randy Derraco
PUBLIC
COMPLAINT CONTROL NUMBER: 54-CC-20230313141659
FACILITY NAME:GONZALEZ FAMILY CHILD CAREFACILITY NUMBER:
198016194
ADMINISTRATOR:GONZALEZ, BERENICEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 269-0245
CITY:LONG BEACHSTATE: CAZIP CODE:
90805
CAPACITY:14CENSUS: 10DATE:
06/22/2023
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Licensee - Citlaly GonzalezTIME COMPLETED:
11:00 AM
ALLEGATION(S):
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Licensee did not provide sufficient supervision to prevent a child from accessing the roof of the facility.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) R. Derraco conducted an unannounced complaint inspection to the above mentioned facility on 06/22/23. LPA arrived at the facility at 9:15 AM and was met by licensee, Citlaly Gonzalez, who guided analyst on a tour of the facility. LPA observed 1 addtional adult and 10 children in care. The purpose of this visit is to deliver complaint findings to the licensee. During the tour, LPA observed the home to be clean and in good repair.

During the course of the investigation, LPA conducted interviews, reveiwed records, and made observations. Individuals interviewed state that they had a discussion with the licensee regarding the behavior of a child in care and that the child climbs onto the awning in the backyard using the swing set. Licensee confirms that the child in care does climb onto the awning in the backyard. Licensee states that she had 3 separate occassions where the child would climb onto the wall and the awning, the most recent being the week ending March 03, 2023. Per licensee, she has attempted to prevent the child from climbing onto the awning (page 1 of 2)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:

DATE: 06/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/22/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 54-CC-20230313141659
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: GONZALEZ FAMILY CHILD CARE
FACILITY NUMBER: 198016194
VISIT DATE: 06/22/2023
NARRATIVE
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by making some backyard furniture inaccessible, however she states that he still climbs up the wall and finds a way up. During LPA's inspection on 03/17/23 and 05/17/23, a swing set was observed in the backyard that is in close proximity (photos taken) to the awning in the backyard. During an interview on 05/17/23, the licensee states that she is thinking about removing the swing set.

Based on LPA’s observations and interviews conducted, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulation, Title 22, Division 12, Chapter 1, article 6 Continuing Requirements, section 102423(a)(2) Personal Rights are being cited on the attached LIC 9099D.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted, report reviewed, and appeal rights provided to Licensee Citlaly Gonzalez.

(page 2 of 2)

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:

DATE: 06/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/22/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 54-CC-20230313141659
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: GONZALEZ FAMILY CHILD CARE
FACILITY NUMBER: 198016194
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/22/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/01/2023
Section Cited
CCR
102423(a)(2)
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102423 Personal Rights (a) each child receiving services from a family child care home shall have certain rights that shall not be waived or abrdiged by the licensee...(2) to receive safe, healthful, comfortable accomodations...this requirement is not met as evidenced by:
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Licensee states that she will remove the swing set from the back yard to prevent any child from using it to climb onto the awning.
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Based on observations and interviews, the licensee waived the right for a child in care to receive safe accomodations by allowing him to climb onto an awning which poses a potential health, safety, and/or personal rights risk to persons in care.
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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.
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:

DATE: 06/22/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/22/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3