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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020741
Report Date: 07/07/2022
Date Signed: 07/07/2022 12:18:00 PM

Document Has Been Signed on 07/07/2022 12:18 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:GALLARDO FAMILY CHILD CAREFACILITY NUMBER:
198020741
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 7DATE:
07/07/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Licensee Gabriela Gallardo TIME COMPLETED:
12:30 PM
NARRATIVE
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At 9:15 am Licensing Program Analysts (LPAs) Roxana Lopez and Veronica Martinez-Garza conducted an announced case management initiated inspection to the above facility on 7/7/2022. LPA’s met with Gabriela Gallardo, Licensee, who guided analyst on a tour of the facility. A risk assessment was conducted upon entry- appropriate PPE was used. The purpose of this inspection is due to licensee’s request for a capacity increase on 12/07/2021. Currently, the licensee’s capacity is eight. Licensee wishes to increase to a capacity of fourteen. Per Licensee, family members residing in the home are 1 adult and 1 child. Per licensee, operation hours will be Monday to Friday 8:00AM to 6:00PM. There was 7 children present upon arrival, 3 of them being infants. The licensee was observed no to be operating within the license capacity limitations. A small family day care home may provide care for more than six and up to eight children- At least one child is enrolled in and attending kindergarten or elementary school and a second child is at least six years of age. During inspection licensee called parents and C1 was picked up at 9:38 am. This poses and immediate risk to the health and safety of children in care. Civil penalties were assessed. A current children’s roster was available for review.

All areas identified on the facility sketch were inspected, including but not limited to, off limit areas. This is a one-story home which consists of 3 bedrooms, 2 bathrooms, kitchen, dining room, living room, den, garage, front yard and backyard (fenced).

Per Licensee, main care areas include the living room, 1 bedroom, den, backyard(fenced), 1 bathroom and dining room. Areas that will be used by children were inspected for safety, comfort, cleanliness, telephone service (cell phone), ventilation and heating (central). LPAs did observe that there is a fireplace located in the living room which is barricaded. Detergents, cleaning compounds, medicines, sharp objects and hazardous items that can pose a danger to children are inaccessible in areas designated for children. The Licensee states that there are no poisons at the facility. The Licensee was advised that any poisons must be locked with a key or combination lock. The valve on the 2A10BC fire extinguisher indicates fully charged, as indicated on receipt submitted or service tag observed---------------------------------------------------------pg.1 of 4-----------------
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Roxana Lopez
LICENSING EVALUATOR SIGNATURE: DATE: 07/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/07/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: GALLARDO FAMILY CHILD CARE
FACILITY NUMBER: 198020741
VISIT DATE: 07/07/2022
NARRATIVE
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Last serviced 3/24/2022. Smoke and carbon monoxide detectors were tested and are operable. Fire/disaster drill log was also current, last drill conducted on 06/14/2022.

Based on the Facility Sketch submitted, areas off limits to children and parents are: 2 bedrooms, 1 bathroom, garage, and front yard. Licensee states that the rooms will stay locked during the hours of operation. LPA’s observed all off limits area to be inaccessible to the children in care. The Licensee understands that licensing staff may have access to off-limit areas during inspection visit if necessary.

The children will use the back yard for outdoor play, which was observed to be fenced. Outdoor area was observed to be safe. LPAs observed that outdoor equipment had spider webs and was dirty throughout. LPAs observed that the portable sink was dirty and clogged (approximately 1 inch of water). The Licensee states that there are no firearms, weapons, or bodies of water on the premises.

There are toys available for children. The Licensee provides food for children in care. If food is not provided and food is brought from the children’s homes; container shall be labeled with child’s name and properly stored or refrigerated. All required postings were observed. Children’s records were reviewed and are complete. LPA issued a copy of the LIC 857 Children’s Records Review and the LIC859 Staff Records Review to the licensee during this inspection.

Licensee currently has 1 assistant. Licensee and assistant have completed required Pediatric First Aid and CPR which training expires, 05/2024 and the Mandated Reporter Training on file. Licensee and assistant also have required immunization's. There are first aid supplies available.

Children nap on toddler beds and mats in the living room and den area.

Licensee states that they are currently caring for infants. LPA 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. 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.----------------------------------------------------------pg. 2 of 4---------------------------------------------------
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Roxana Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2022
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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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: GALLARDO FAMILY CHILD CARE
FACILITY NUMBER: 198020741
VISIT DATE: 07/07/2022
NARRATIVE
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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 Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs, Trampolines and/or any other item that fall into these categories are not permitted in a family child care facility.

Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.

LPA advised the licensee to access forms, regulations and quarterly updates on line at: www.ccld.ca.gov.

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.

Licensee is seeking to provide care for 14 children 0-12 years old. A fire clearance has been granted as of 3/15/2022. Based on today’s observation the capacity increase application will be reviewed by Licensing Program Manager (LPM).

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.

LPAs Roxana Lopez and Veronica Martinez-Garza informed licensee Gabriela Gallardo that this report dated 7/7/2022 document(s) 1 Type A citation which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.
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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Roxana Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2022
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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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: GALLARDO FAMILY CHILD CARE
FACILITY NUMBER: 198020741
VISIT DATE: 07/07/2022
NARRATIVE
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Also, LPAs Roxana Lopez and Veronica Martinez-Garza informed the licensee Gabriela Gallardo to provide a copy of this licensing report dated 7/7/2022 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

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 and report was reviewed with Licensee, Gabriela Gallardo.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Roxana Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2022
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 07/07/2022 12:18 PM - It Cannot Be Edited


Created By: Roxana Lopez On 07/07/2022 at 11:41 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: GALLARDO FAMILY CHILD CARE
FACILITY NUMBER: 198020741

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/07/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/07/2022
Section Cited
HSC
1597.44(a)

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1597.44 (a) Small family day care homes; number of children: A small family day care home may provide care for more than six and up to eight children, without an additional adult attendant, if all of the following conditions are met: (a) At least one child is enrolled in and
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During inspection C1 was picked up Per Licensee she will keep 6 children and ensure that it won't overlap. Licensee, will submitted a Lic 308 Declaration form with her written plan.
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attending kindergarten or elementary school and a second child is at least six years of age. This requirements was not met as evidence by: Based on LPA's observations and record's review Licensee had 7 children under the age of 5 present on 7/7/2022.
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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:Brandi VanOosten
LICENSING EVALUATOR NAME:Roxana Lopez
LICENSING EVALUATOR SIGNATURE:
DATE: 07/07/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/07/2022


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