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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020811
Report Date: 07/31/2024
Date Signed: 07/31/2024 12:21:08 PM

Document Has Been Signed on 07/31/2024 12:21 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:GONZALEZ FAMILY CHILD CAREFACILITY NUMBER:
198020811
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 6DATE:
07/31/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:00 PM
MET WITH:Evelia GonzalezTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
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On 7/31/2024 at 12:00 pm Licensing Program Analysts (LPAs), Carolyn Tuba and Priscilla Ochoa conducted an unannounced Proof of Correction (POC) inspection to ensure the deficiencies cited on 7/15/2024 during an Annual visit have been corrected. A COVID risk assessment was conducted. LPAs met with Licensee, Evelia Gonzalez and LPAs observed 6 children in care with 2 adults.

During the visit LPAs, were provided proof of 15-minute sleep log for 2 infants in care, Mandated Reporting Training Certificates for Licensee and her assistant that were completed on 7/23/2024 and need to be renewed every 2 years. Licensee and assistant provided proof of Pediatric CPR/1st Aid cards EMSA approved, which expires 7/2026.

LPAs cleared the deficiencies on this date and issued Proof of Correction (POC) clearance letters during the visit.

At this time, the facility is in compliance with California Code of Regulations Title 22. Therefore, no deficiencies are being cited.

A notice of site visit was given to Licensee and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Licensee, Evelia Gonzalez.



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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Carolyn Tuba
LICENSING EVALUATOR SIGNATURE: DATE: 07/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/31/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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