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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198021232
Report Date: 07/01/2024
Date Signed: 07/01/2024 03:56:06 PM

Document Has Been Signed on 07/01/2024 03:56 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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:GUTIERREZ FAMILY CHILD CAREFACILITY NUMBER:
198021232
ADMINISTRATOR/
DIRECTOR:
GUTIERREZ, LOURDESFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(213) 880-5551
CITY:LOS ANGELESSTATE: CAZIP CODE:
90065
CAPACITY: 14TOTAL ENROLLED CHILDREN: 3CENSUS: 1DATE:
07/01/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:22 PM
MET WITH:Lourdes GutierrezTIME VISIT/
INSPECTION COMPLETED:
04:15 PM
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Licensing Program Analyst (LPA) Veronica Martinez Garza conducted an unannounced Annual/Random inspection at the above facility on 07/01/24 at 01:22 p.m. LPA met with Lourdes Gutierrez, licensee who guided analyst on a tour of the facility. There was 01 child present during this inspection. Per licensee, 03 children are enrolled. Operation hours are Monday through Friday from 07:30pm – 06:00pm.

This is a one-story home which consists of 2 bedrooms, 3 bathrooms, living room, dining room, kitchen, converted garage (day care room), deck (used for outdoor play), front yard (fenced), side yard (fenced), and back yard (fenced). Licensee’s home is in a downhill slope and has placed child proof gates that are well anchored on top and bottom of the stairs. LPA observed all child proof gates have signs that serve as reminders to keep the gate doors closed and to watch your step. Licensee also has placed caution tape on every step as a preventative measure. Areas accessible to children include converted garage (day care room), living room (day care room), 1 bedroom, 2 bathrooms (1 located inside the converted garage and the 2nd bathroom located in the hallway across from the off-limit bedroom), deck (used for outdoor play). Areas off-limits to children and parents include 1 bedroom with private bathroom which is made inaccessible, 1 bathroom, kitchen, side yards (fenced), back yard (fenced). Per licensee, there are no pets on the premises. Per licensee, family members residing in the home are 2 adults and 0 minors. All individuals present in the home have obtained a criminal record clearance or exemption prior to working, residing, or volunteering in a licensed home and are identified on the attached LIC811.

LPA toured all areas identified on the facility sketch used by children during this visit and were inspected for safety, comfort, and cleanliness. Tour began in the living room/dining room where LPA observed age-appropriate toys, equipment, and materials for children. Adjacent to the living room/dining room there are 2 steps leading towards 2 bedrooms and 1 bathroom. Licensee has requested to add (1) bedroom (next the children’s bathroom) as an area accessible to children. Per licensee, the bedroom will be used for infants to nap. LPA observed (1) play pen in the bedroom. LPA observed that the play pen does not hinder the entrance or exit to and from the space they are sleeping in. Older children use mats as napping equipment.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE: DATE: 07/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/01/2024
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 4
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: GUTIERREZ FAMILY CHILD CARE
FACILITY NUMBER: 198021232
VISIT DATE: 07/01/2024
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The play pen does not have anything hanging on the sides or on top. Licensee understands that the infants napping in the bedroom must always have the door open. LPA observed that the children’s bathroom was safe and in sanitary conditions. Next to the living room/dining room is the kitchen. Licensee has a well mounted gate between the living room/dining room and kitchen to make the kitchen inaccessible to children. There’s also a first aid kit readily available.

LPA observed the following required posted documentation in the living room of the facility: Facility License, Publication (PUB) 394- Notification of Parent Rights and Licensing Form (LIC) 9148- Earthquake Preparedness form. LPA reviewed facility records LIC 610- Emergency Disaster Plan and Disaster drill log. All homes shall conduct fire and disaster drills at least once every six months and document the date and time of each drill. Last drill conducted was 06/26/24. Children’s roster was available during this inspection and was observed to be current.

LPA did not observe any pools, spas, hot tubs, fishponds, or similar bodies of water during the inspection.

Licensee does understand that licensing staff may have access to off-limit areas during inspection visit if necessary. **Rooms that are off-limits need to be made inaccessible during operating hours**

Per licensee, parents provide children’s snacks and lunch. Licensee refills children’s water as needed. Licensee was advised that if food is brought from the children’s homes, all containers must be labeled with the child’s name and properly stored or refrigerated. There is telephone service via a landline. There is ventilation and heating.

Detergents, cleaning compounds, medications, and other items which could pose a danger to children were observed to be inaccessible to children. The licensee states that there are poisons in the home and are maintained locked. Licensee understands that storage areas for poisons must be locked with a key or combination lock. Per licensee, there are no firearms or weapons stored in the home.

At 01:40 p.m. smoke and carbon monoxide detectors were tested and are operable. The valve on the required 2: A10 BC fire extinguisher indicates fully charged and was last purchased on 06/03/23, per the attached receipt. Per licensee, she purchased (2) fire extinguishers online and is waiting to receive both extinguishers. Licensee showed LPA proof of purchase for both fire extinguishers. Purchase date is 06/27/24 and the size is 2: A10 BC. Per State Fire Marshall standards, fire extinguishers shall be serviced annually.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE:

DATE: 07/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2024
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: GUTIERREZ FAMILY CHILD CARE
FACILITY NUMBER: 198021232
VISIT DATE: 07/01/2024
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The isolation area for sick children waiting to be picked up is in the living room with supervision.

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

Currently children use the front deck (fenced) for outdoor play with adequate shade and age-appropriate play equipment for children in care. Per licensee, currently children are not using the front yard for outdoor play; however, (1) day care child uses the sandbox. LPA observed the sandbox is covered. Licensee understands that children should be supervised at all times. LPA advised licensee to check with the American Standard Testing Materials for Playground Guidelines and/or to use the manufactures recommendations for the playground equipment in efforts to be more in line with safety guidelines.

Children’s records were reviewed for (LIC) 282- Affidavit Regarding Liability Insurance, Immunization's Records, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, and LIC 995A Notification of Parents’ Rights, LIC 9227- Infant sleep form (0-12 months, and documentation of 15-minute Infant Sleep Check (0-24 months). LPA observed Child 1 (C1) and C3 are missing the documentation of 15-minute infant sleep check. LPA provided consultation.

Licensee’s records were reviewed for approved Proof of immunizations against measles, pertussis and influenza or influenza declination, TB clearance or risk assessment, LIC 9108- Statement Acknowledging Requirement to Report Child Abuse and current Mandated Reporter Training Certificate. Licensee’s Mandated Reporter Training expired on 01/19/25. Licensee’s Pediatric CPR/FA expires on 01/21/25.

AB1207 Mandated Child Abuse Reporting – On or before March 30, 2018, any person who works in a child care facility shall complete the training and renew the training every 2 years. Website provided: https://www.mandatedreporterca.com/training/child-care-providers

The licensee is operating within proper capacity and ratios. LPA observed licensee to be present at the home and providing adequate care and supervision.

Licensee is 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-andresources/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. LPA provided consultation.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE:

DATE: 07/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2024
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: GUTIERREZ FAMILY CHILD CARE
FACILITY NUMBER: 198021232
VISIT DATE: 07/01/2024
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No infant walkers, No baby bouncers, No Johnny jumpers, No exersaucers and any other item that falls into that category.

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/.

Licensee was 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 Child Care 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.

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 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.

Licensee Lourdes Gutierrez confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

At this time, the facility is in compliance with California Title 22 Regulations. Therefore, there are no deficiencies being issued today.

Exit interview conducted and report was reviewed with the licensee Lourdes Gutierrez.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE:

DATE: 07/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2024
LIC809 (FAS) - (06/04)
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