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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400147
Report Date: 11/04/2021
Date Signed: 11/04/2021 11:58:00 AM

Document Has Been Signed on 11/04/2021 11:58 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:GUTIERREZ FAMILY CHILD CAREFACILITY NUMBER:
198400147
ADMINISTRATOR:GABRIELLA GUTIERREZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 422-7712
CITY:LONG BEACHSTATE: CAZIP CODE:
90805
CAPACITY: 14TOTAL ENROLLED CHILDREN: 9CENSUS: 6DATE:
11/04/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Assistant - Stephanie JaraTIME COMPLETED:
12:15 PM
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Licensing Program Analyst (LPA) R. Derraco conducted an unannounced required 1 year inspection to the above facility on 11/04/21. LPA arrived at the facility at 09:15 AM and met with assistant Stephanie Jara, who guided analyst on a tour of the facility. Assistant states that licensee was out buying groceries and will return shortly. At 10:30 AM, licensee Gabriella Gutierrez arrived to the facility. Per Licensee, there are 9 children that are currently enrolled. There were 6 children present upon arrival.

This is a one story home which consists of 3 bedrooms, 2 bathrooms, kitchen/dining room, 2 living rooms, a detached garage, front yard (fenced) and backyard (fenced). The off limit areas include 2 bedrooms, 1 bathroom, kitchen, dining area, 1 living room, and a detached garage. The main care area is located in the 2nd living room. LPA observed a wall mounted television, a covered wall mounted heater, a pull down fire alarm, a couch, a child size table and chairs, and age appropriate toys. A baby gate was observed to separate the main care area from the off limits dining room and kitchen. LPA observed bedroom 1 to be used for day care services. A baby gate was observed in the doorway of bedroom 1. Additional age appropriate toys/materials, and a ceiling fan were observed. A door in bedroom 1 was observed to lead to the restroom designated for children in care. LPA observed the restroom to be clean and free of defects. A child lock was observed beneath the bathroom sink. Per licensee, cleaning supplies are kept locked in the off limits kitchen beneath the sink. LPA observed the backyard play area to have additional age appropriate toys and materials, a locked storage bin, a mini camper and an off limits detached garage. LPA observed the back yard to have perimeter fencing. Additional fencing was observed around the mini camper making it inaccessible. LPA observed a jacuzzi in the backyard to have a locked cover. Per licensee children are supervised in the back yard at all times. Licensee states that a bench is moved over to prevent children from having access to the jacuzzi area. Additional tables, chairs and shade were observed in the backyard area. The front yard play area is also used for outdoor play time for children in care. LPA observed a swing, slide, and perimeter fencing in the front yard play area. Licensee states children use front yard play area
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SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE: DATE: 11/04/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/04/2021
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 8
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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: GUTIERREZ FAMILY CHILD CARE
FACILITY NUMBER: 198400147
VISIT DATE: 11/04/2021
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for children awaiting pick up and that she mainly uses the back yard play area for outdoor play time.

LPAs observed that there is a wall heater in the off limits living room that has a cover. The licensee states that she provides food for children in care. Per licensee, isolation area for children showing signs of illness will be located in the off limits living room. Individuals who reside in the home were noted and discussed. Per Licensee, they currently have one assistant. All adults present in the home have obtained a criminal record clearance or exemption prior to working, residing or volunteering in the licensed childcare home. 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 states that there are no firearms stored in the home. All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. There is telephone service via a cellphone that is used and the cellphone stays at the facility during operation hours. Per Licensee, the home is equipped with wall mounted air conditioning units. The licensee states that there are no poisons in the home and understands that storage areas for poisons must be locked, not just inaccessible. The valve on the required 2A 10BC fire extinguisher indicates fully charged and was serviced on 07/10/21, as indicated on service tag. Smoke and carbon monoxide detectors were tested and are operable. LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs. Per license, she has a dog that is kept in the off limits bedroom.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee [facility representative] 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.

The licensee and other personnel have completed training on preventive health practices including Pediatric


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SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:

DATE: 11/04/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2021
LIC809 (FAS) - (06/04)
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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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: GUTIERREZ FAMILY CHILD CARE
FACILITY NUMBER: 198400147
VISIT DATE: 11/04/2021
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First Aid and CPR. The licensee's Pediatric First Aid and CPR expires on 06/2023. LPAs observed that the Licensee and assistant do have proof of the Mandated Reporter AB 1207 compliant Child Care Training Certificate on file. File review was observed to have proper mandated immunization records. Children’s records were reviewed, including emergency information and were observed to be complete. A current children’s roster was available for review. Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted. Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.

Incidental Medical Services (IMS):
IMS was discussed with licensee. Per licensee, there are no children enrolled that require IMS at this time. 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 advised the licensee to access forms, regulations and quarterly updates online at: www.ccld.ca.gov.

At this time, the licensee is in compliance with California Code of Regulations Title 22. No deficiencies cited.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

A notice of site visit was given and must remain posted for 30 days.

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

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SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:

DATE: 11/04/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2021
LIC809 (FAS) - (06/04)
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