198019135-1-28-2025-33-CC-JSCS-DCYQH3-20250116111027

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198019135
Report Date: 01/16/2025
Date Signed: 01/28/2025 08:58:07 AM

Document Has Been Signed on 01/28/2025 08:58 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	GONZALEZ FAMILY CHILD CARE		FACILITY NUMBER:	198019135
ADMINISTRATOR/ DIRECTOR:	GONZALEZ, MARIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 974-5772
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90032
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 5	DATE:	01/16/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:30 AM
MET WITH:	Maria Elena Gonzalez		TIME VISIT/ INSPECTION COMPLETED:	11:30 AM

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

On Thursday, January 16, 2025, Licensing Program Analysts (LPA’s) Staicy Perry and Joanne Solorio Campos conducted an unannounced annual inspection at the above facility. Licensing staff met with Licensee Maria Gonzalez, who guided staff on a tour of the facility. Adults in the home were discussed, and all have criminal record clearance. This is a large Family child care home. There were 6 children present upon arrival. Licensee states that there are currently 6 children enrolled. The licensee is observed to be operating within ration for a Large Family Child Care Home. A current children’s roster was available and is current. Hours of operation are Mon-Fri 7:00 AM - 6:00 PM.

This is a two-story home which consists of 4 bedrooms, 3 bathrooms, laundry room, kitchen, dining room, living room with a fireplace inaccessible to children with a barricade, family room, garage, backyard (fenced) and front yard. The stairs leading to the second story were observed to be barricaded with two gates making inaccessible to the children. Areas off limits include the whole second story bedroom #1, bedroom #3, Bedroom #4, Living room, dining room, laundry area, kitchen, and front yard.

All areas identified on the facility sketch were inspected. Areas accessible to the children are the daycare room, bathroom in the daycare room, bedroom #2 and backyard for play (fenced). All areas were observed to be clean and orderly with age-appropriate toys, free of loose and sharp parts. Facility was observed to have ventilation and heating for the safety of the children.

SUPERVISORS NAME: Katrina Chicote
LICENSING EVALUATOR NAME: Joanne Solorio Campos
LICENSING EVALUATOR SIGNATURE:	DATE: 01/16/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2025

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

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: GONZALEZ FAMILY CHILD CARE	FACILITY NUMBER: 198019135
	VISIT DATE: 01/16/2025

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

There is a working telephone maintained in the home. Detergents, cleaning compounds, medications, and other items which can pose a danger to children are inaccessible.

LPA’s observed the following required posted documentation in the main entry way on the door of the facility: Facility License, Publication (PUB) 394- Notification of Parent Rights and Licensing Form (LIC) 9148- Earthquake Preparedness form. LPA’s reviewed facility records for LIC 9040- Facility Roster, LIC 610- Facility Disaster Plan and Disaster drill log. Last drill was conducted on 12/12/24

LPA did not observe any pets at time of inspection and Licensee confirms she has no pets. Per Licensee, there are no weapons, firearms in the home and there are no bodies of water around the premises. LPA’s did not observe any of the above mentioned.

The valve on the required 2A 10BC fire extinguisher indicates fully charged and was purchased on 12/23/24. Smoke and carbon monoxide detectors are in operable condition. LPA’s observed First Aid kit and was inventoried for necessary supplies.

The Licensee has current Pediatric First Aid and CPR and expires 06/2025, Proof of immunization against influenza, pertussis, and measles and Mandated Reporter Training was completed on 06/2025. Licensee’s assistant’s file was also observed to be complete.

At approximately 9;30am children’s records were also reviewed and were observed to not be complete. LPA’s observed individual Sleeping Plan (LIC9227) to be missing from 2 out of the 6 children’s files, which poses a potential risk to the health and safety of children in care.

SUPERVISORS NAME: Katrina Chicote
LICENSING EVALUATOR NAME: Joanne Solorio Campos
LICENSING EVALUATOR SIGNATURE:	DATE: 01/16/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2025

LIC809 (FAS) - (06/04)

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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: GONZALEZ FAMILY CHILD CARE	FACILITY NUMBER: 198019135
	VISIT DATE: 01/16/2025

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

To improve the quality and value of the new inspection process, a survey may 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 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.

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’s 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-and-resources/safe-sleep as an additional resource. Licensee currently does care for infants and LPA’s 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/.

Appeal Rights were provided and reviewed.

SUPERVISORS NAME: Katrina Chicote
LICENSING EVALUATOR NAME: Joanne Solorio Campos
LICENSING EVALUATOR SIGNATURE:	DATE: 01/16/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2025

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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: GONZALEZ FAMILY CHILD CARE	FACILITY NUMBER: 198019135
	VISIT DATE: 01/16/2025

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

Centers and Family Child Care Homes 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.

During the exit interview, the licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

The facility was found not to be in compliance per Title 22 regulations. Based on this information, the following deficiencies on the attached LIC 809D 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 notice of site visit was given and must remain posted for 30 days.

Exit interview was conducted with Licensee Maria Elena.

SUPERVISORS NAME: Katrina Chicote
LICENSING EVALUATOR NAME: Joanne Solorio Campos
LICENSING EVALUATOR SIGNATURE:	DATE: 01/16/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2025

LIC809 (FAS) - (06/04)

Page: 4 of 5

Document Has Been Signed on 01/28/2025 08:58 AM - It Cannot Be Edited

Created By: Joanne Solorio Campos On 01/16/2025 at 10:37 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: GONZALEZ FAMILY CHILD CARE	FACILITY NUMBER: 198019135
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/16/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102425(c)

Infant Safe Sleep

An Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be completed for each infant up to 12 months of age the provider has in care and included in the infant's file at the facility. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observations, interview, record review, the licensee did not comply with the section cited above, LPA’s observed individual Sleeping Plan (LIC9227) to be missing from 2 out of the 6 children’s files, which poses a potential risk to the health and safety of children in care.
	POC Due Date: 01/24/2025
	Plan of Correction
1 2 3 4	Licensee states that she will have parents complete LIC 9227 and place in child's file.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Katrina Chicote

LICENSING EVALUATOR NAME:

Joanne Solorio Campos

LICENSING EVALUATOR SIGNATURE:

DATE: 01/16/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2025

LIC809 (FAS) - (06/04)

Page: 5 of 5