198016950-4-30-2026-54-CC-ACAN-DTMR58-20260430124244

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198016950
Report Date: 04/30/2026
Date Signed: 04/30/2026 12:43:14 PM

Document Has Been Signed on 04/30/2026 12:43 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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	GUTIERREZ FAMILY CHILD CARE		FACILITY NUMBER:	198016950
ADMINISTRATOR/ DIRECTOR:	GUTIERREZ, GABRIELA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(562) 508-3810
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90814
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 12	CENSUS: 4	DATE:	04/30/2026
TYPE OF VISIT:	Annual/Required	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:45 AM
MET WITH:	Facility Representative Gabriela .A. Gutierrez		TIME VISIT/ INSPECTION COMPLETED:	12:50 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA) Ashley Calderon conducted an unannounced annual/ required inspection to the above facility. LPA arrived at the facility identified self, and met with Facility Representative Gabriela .A. Gutierrez who allowed LPA entrance into the facility. LPA was guided on a tour of the facility along side Staff Assistant G. Gutierrez. LPA observed 3 children upon arrival with staff assistant; Licensee was not present. At 10:20am additional child arrived at the facility; making census 4. There was 1 infant in care and 2 infants enrolled. Facility operation hours are Monday through Friday 6:00AM to 6:00PM. Facility is licensed for a Large Family Day Care, Capacity 14. The facility is observed to be operating within the license capacity limitations. Individuals who reside in the home were noted and discussed; individual adult present is fingerprinted cleared. This is a one-story duplex which consists of: 3 bedrooms, 2 bathrooms, kitchen, dining room, living room, side yardand front yard.(fenced). On limits: The living room (activity room), bedroom #2, 1 bathroom in the hallway and the front yard (fenced). Off limits: Bedroom #1 and Bedroom #3, sideyard and master bathroom. All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. Per staff assistant facility does not provide transportation to children. The restroom that children use was observed to be safe and sanitary. LPA observed that inside and the outdoor yard has toys and other materials for children to play with. LPA did not observe any infant walkers, baby bouncers, inclined chairs, baby saucers, or any similar items at the facility. Play yard had no bodies on premises; no pools, spas, hot tubs, fishponds, or similar bodies of water during the inspection.

NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Ashley Calderon
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 04/30/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2026

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)

Page: 2 of 5

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: GUTIERREZ FAMILY CHILD CARE	FACILITY NUMBER: 198016950
	VISIT DATE: 04/30/2026

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Facility provides food for children in care. Staff assistant stated that there are no firearms stored in the home. There are two dogs observed inaccessible to children in care during time of visit. There is telephone service via cellphone and the phone stays at the facility during operation hours. There is ventilation via fans and a/c and heating unit. Detergents, cleaning compounds, medications, and other items which could pose a danger to children were observed to be inaccessible to children located in inaccessible cabinets in the kitchen , bathroom in hallway area, observed to have child latches for inaccessibility. Off limit bedrooms were observed with children safety door knob covers and gates in front of doors for inaccessibility. Staff assistant stated that there are no poisons in the home and understands that storage areas for poisons must be locked when they are brought into the home. The valve on the required 2A10BC fire extinguisher indicates fully charged and was serviced on 11/4/25, as indicated on service tag located in the hallway and consultation was given. Smoke and carbon monoxide detectors are interconnected per staff assistant; during visit they were tested and are operable. There is a fireplace in the living room; it is barricade with a play pen in front of the mantle, a metal screen around the fire place, and in front of fireplace there is a glass door and behind the door there is a screen; no latches for inaccessibility and neither of the barricades were bolted for inaccessibility therefore consultation was given. Infants sleep in the living room/activity room in appropriate sleeping arrangements and cribs were observed. LPA observed two portable play yards for infants in care. Cribs or play yard did not hinder the entrance or exit from the sleeping space. LPA at 11:10am observed there were no firm mattresses for infant play yards sleep accommodations required by Title 22 and staff assistant stated their are fitted sheet that go over the pad that comes with the play yards, deficiency cited. Cribs and play yards were observed to be free of loose articles and objects and no objects were observed to be hanging above or attached to the side of the crib. LPA did not observe any infants swaddled while in care. Per interview with Facility Representative regarding infants Staff assistant stated Child #3 thought they didn't need one because they are over 12 months and Child #4 has a 15 min sleep log as they are younger. 15 min sleep log was observed for Child #4 only, consultation was provided.

LPA Calderon conducted record review: The licensee file had a valid Pediatric First Aid and CPR expires 6/7/2026 and their Mandated Reporter (M.R) training expires 5/27/27. During visit Licensee was not present; LPA asked what time will Licensee return; staff assistant G.Gutierrez stated they are out of the country, deficiency was given as Licensee is unable to supervise 80% of the hours of operation and their absent exceeds 20% of facility hours per day. Staff assistant record was reviewed and they are qualified to stay alone with children for 20% of licensee temporary absent their Pediatric 1st aid and cpr expires 6/22/2027 and M.R exp- 4/9/27. LPA Calderon conducted interview with staff assistant.

NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Ashley Calderon
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 04/30/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2026

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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: GUTIERREZ FAMILY CHILD CARE	FACILITY NUMBER: 198016950
	VISIT DATE: 04/30/2026

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

LPA advised that if a child shows signs of illness, he/she/they shall be separated from other children. Children’s records were reviewed, including emergency information, and were observed to be complete. Facility conducts fire and disaster drills; last drill documented was conducted on 1/12/2026 based on document review. Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted. Earthquake Preparedness Log was provided to staff assistant to post and informed them to ensure this is posted as part of posting requirements. LPA did not observed odor of smoke, LPA informed staff assistant smoking is prohibited inside a licensed Family Childcare Home. Per staff assistant, currently children are not using Bedroom #2 as it has some storage items; LPA informed staff assistant if Licensee wants to make this room off limit to ensure to report and update LIC999 Facility Sketch- Physical Plant.

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.
Facility representatives were 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 clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Childcare 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 Facility Representatives 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. LPA also informed facility representatives 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. PIN 22-05-CCP
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/.
Facility Representatives were informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, the Facility Representative Gabriela A Gutierrez, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS. Per California Code of Regulations Title 22, facility was given 2 deficiencies. A notice of site visit was given and must remain posted for 30 days. An exit interview conducted and report was reviewed with the Facility Representative Gabriela A Gutierrez.

NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Ashley Calderon
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 04/30/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2026

LIC809 (FAS) - (06/04)

Page: 4 of 5

Document Has Been Signed on 04/30/2026 12:43 PM - It Cannot Be Edited

Created By: Ashley Calderon On 04/30/2026 at 11:55 AM

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: GUTIERREZ FAMILY CHILD CARE	FACILITY NUMBER: 198016950
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/30/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102425(a)(3)

Infant Safe Sleep

(a) There shall be one crib or play yard for each infant who is unable to climb out of the crib or play yard. (3) Mattresses shall be firm and covered with a fitted sheet that is appropriate to the mattress size, fits tightly on the mattress, and overlaps the underside of the mattress so it cannot be dislodged. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on LPA Calderon's observation at 11:10am observed there were no firm mattresses for infant play yards sleep accommodations required by Title 22 and per staff assistant stated their are fitted sheet that go over the pad that comes with the play yards, the licensee did not comply with the section cited above in [2] out of [2 ] play yards with no firm mattress which pose a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 05/08/2026
	Plan of Correction
1 2 3 4	Staff assistant will notify Licensee to have firm mattress for play yards used by infants and submit a picture to LPA Calderon by poc due date.

Type B

Section Cited

CCR

102417(a)

Operation of A Family Child Care Home

(a) The licensee shall be present in the home and shall ensure that children in care are supervised at all times. When circumstances require the licensee to be temporarily absent from the home, the licensee shall arrange for a substitute adult to care for and supervise the children during his/her absence. Temporary absences shall not exceed 20 percent of the hours that the facility is providing care per day. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation during visit Licensee was not present; LPA interviewed staff asssitant and asked what time will Licensee return; staff assistant G.Gutierrez stated they are out of the country, deficiency was given as Licensee is unable to supervise 80% of the hours of operation and their absent exceeds 20% of facility hours per day, the licensee did not comply with the section cited above in [4] out of [4] children in care with no Licensee supervison which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 05/08/2026
	Plan of Correction
1 2 3 4	Staff assistant will notify Licensee and come up with a plan and inform LPA Calderon of the plan and submit it to LPA Calderon by poc due date.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

	Warren Birks
NAME OF LICENSING PROGRAM MANAGER:

	Ashley Calderon
NAME OF LICENSING PROGRAM ANALYST:

LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/30/2026

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2026

LIC809 (FAS) - (06/04)

Page: 5 of 5