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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334843487
Report Date: 03/28/2023
Date Signed: 03/28/2023 12:32:20 PM

Document Has Been Signed on 03/28/2023 12:32 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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:GONZALEZ FAMILY CHILD CAREFACILITY NUMBER:
334843487
ADMINISTRATOR:GONZALEZ,VERONICAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(951) 279-5109
CITY:CORONASTATE: CAZIP CODE:
92879
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 11DATE:
03/28/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
11:55 AM
MET WITH:Veronica Gonzalez, LicenseeTIME COMPLETED:
12:45 PM
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On date and time listed, Licensing Program Analyst Elyse Jones, arrived at the facility to conduct a Case Management inspection to ensure the pool meets the Title 22 regulations.

On March 10, 2023 LPA Jones was informed by the Licensee that the pool construction was complete, she would like the pool to be inspected and to take the backyard off limits.

During today's inspection the pool gate was measured and the door was tested to ensure it is self latching/closing.

As of today, the pool gate measured 5ft, latch is no more than 6in from the top of gate and has a self latching/closing door. The pool fencing is in compliance with Title 22 regulations. The backyard is on limits as of today.

A notice of site visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door 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 Veronica Gonzalez, Licensee.

SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Elyse Jones
LICENSING EVALUATOR SIGNATURE: DATE: 03/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/28/2023
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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