376630128-11-1-2024-20-CC-DSTS-DALQPH-20241101122046

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376630128
Report Date: 11/01/2024
Date Signed: 11/01/2024 12:20:53 PM

Document Has Been Signed on 11/01/2024 12:20 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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME:	GONZALEZ, KAREN FAMILY CHILD CARE		FACILITY NUMBER:	376630128
ADMINISTRATOR/ DIRECTOR:	KAREN GONZALEZ		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(619) 513-9292
CITY:	BONITA	STATE: CA	ZIP CODE:	91902
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 0	DATE:	11/01/2024
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	10:40 AM
MET WITH:	Karen Gonzalez		TIME VISIT/ INSPECTION COMPLETED:	12:30 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 11/01/2024 Licensing Program Analyst (LPA) Dana Stevens conducted an announced pre-licensing inspection with applicant, Karen Gonzalez. Also present in the facility was applicant's sister/assistant, Jessica Jimenez. Purpose of the inspection is to ensure that the home is in compliance with standards established in CCR, Title 22, Division 12, Chapter 3, for Family Child Care Homes. This single story, three bedroom, two bath home was toured and inspected. Applicant will use the following areas for child care: Kitchen, living room, dining room, bedroom #1, bedroom #2, and hall bathroom. Off limits areas include: master bedroom, and bath, garage and laundry room. They are made inaccessible to day care children through the use of door locks, and safety latches. Applicant will utilize the backyard for outdoor activities, it is properly fenced. The applicant understands total supervision is required during outdoor play. There are no bodies of water observed during time of visit. The fire extinguisher is rated 2A 10B:C. Smoke and carbon monoxide detectors meet requirements and are operational. All poisons, detergents, cleaning compounds, and medicines are inaccessible to children in care and are located in off limit areas with cupboard latches and door locks and secured out of reach of children. Children’s toys and play equipment are available. The applicant has a working telephone/cell phone. Applicant indicated there are no firearms or other weapons in the home. Applicant maintains documentation of proof of control of property for review by the Department. Applicant completed Mandated Reporter AB1207 and 8 hours of preventative health. Applicant's Pediatric CPR and First Aid certifications are current and expire 5/2026. Assistant's Pediatric CPR and First Aid certifications are current and expire 1/2026. Required documents are posted. Applicant and assistant have criminal record clearances and/or exemptions on file.

SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Dana Stevens
LICENSING EVALUATOR SIGNATURE:	DATE: 11/01/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2024

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: GONZALEZ, KAREN FAMILY CHILD CARE	FACILITY NUMBER: 376630128
	VISIT DATE: 11/01/2024

NARRATIVE

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Applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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

Any minor upon their 18th birthday must be fingerprinted within 30 days. Immunization records per SB792 were reviewed and are in compliance. LPA advised that prior to making alterations or additions to the home or grounds, the applicant shall notify the Department of the proposed change. Applicant states they are financially secure to operate a family child care home for children and will comply with all regulations and laws governing family child care homes. The hours of operation are Monday through Friday, 7:00 a.m. to 5:00 p.m.

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) or (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 reviewed with applicant the LIC 311D, Forms/Records to Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. Entrance Checklist was provided to the applicant.

LPA discussed the maximum capacity for a Large family childcare home: 12 children with no more than 4 infants; 14 children with no more than 3 infants, one child in kindergarten or elementary school and one child at least age six, including children under age 10 who live in the home.

SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Dana Stevens
LICENSING EVALUATOR SIGNATURE:	DATE: 11/01/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2024

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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: GONZALEZ, KAREN FAMILY CHILD CARE	FACILITY NUMBER: 376630128
	VISIT DATE: 11/01/2024

NARRATIVE

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The applicant provided proof of control of property. Because the applicant rents/leases the home, proof of landlord notification is required. The LPA observed the Property Owner/Landlord Notification form (LIC9151) that the applicant confirms was provided to the property owner/landlord. The applicant obtained a signed Property Owner/Landlord Consent form (LIC 9149).

LPA discussed the safe sleep regulations with applicant 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 applicant 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.

Megan’s Law - Family Child Care Homes On this date, 09/17/2024 the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

Applicant was informed of the MyChildCarePlan.org site, 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.

Exit interview conducted and report was reviewed with the applicant, Karen Gonzalez.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-carelicensing/subscribe and select the Child Care option to receive email communication.

SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Dana Stevens
LICENSING EVALUATOR SIGNATURE:	DATE: 11/01/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2024

LIC809 (FAS) - (06/04)

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