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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566215609
Report Date: 05/14/2024
Date Signed: 05/14/2024 04:37:44 PM

Document Has Been Signed on 05/14/2024 04:37 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, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:GONZALEZ FCC AKA LULU DAY CAREFACILITY NUMBER:
566215609
ADMINISTRATOR/
DIRECTOR:		BLANCA L. GONZALEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 612-3481
CITY:OXNARDSTATE: CAZIP CODE:
93033
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 4DATE:
05/14/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:00 PM
MET WITH:Blanca L GonzalezTIME VISIT/
INSPECTION COMPLETED:
02:15 PM
NARRATIVE
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 THIS IS AN AMENDED REPORT
On May 14, at 12:00 PM Licensing Program Analyst (LPA) Laura Villanueva conducted a Case Management-Deficiencies. LPA met with Blanca L. Gonzalez and explained the purpose of the visit. LPA conducted a tour of the facility inside and outside with Licensee. LPA observed a total of 4 children under the care and supervision of Licensee and her daughter,

As LPA walked to the front door, animal feces was on the left side of the walkway. LPA knocked on the front door. No one responded. LPA observed a camera mounted on the side of the house. LPA called the 2 phone numbers on the facility profile with no response. LPA asked the gardener (Licensee's father) if anyone was home. Gardener went to the back of the home and then the front door was opened by Licensee's daughter. LPA observed licensee's daughter caring for her own 2 children while 2 child care children were present. Licensee stated that her daughter was helping today due to her assistant having an appointment. LPA informed Licensee that her daughter is not on the Guardian generated staff roster. Licensee stated that her daughter was fingerprinted and that she had the clearance letter. LPA asked Licensee to provide a copy of the clearance letter. Licensee had letter of fingerprints being taken but no clearance.

During tour of the home, LPA observed 2 stacked cribs with wooden bars on the front. No infants were inside. The cribs were enclosed keeping any infant trapped inside. LPA advised Licensee that those cribs were not appropriate for any child due to the child being contained in a cage like space. Licensee stated that the other LPAs that had visited, they did not say anything about them. LPA informed licensee that a deficiency can be issued and then she can appeal. Licensee stated that a citation was not necessary. She will have her son in law remove them today.

LPA observed child safety locks on the children's bedroom and the bedroom that is used for napping. LPA advised Licensee that the child locks are only to be used for rooms that are off limits to the children. The children need to have access to the restroom. Licensee informed LPA that an infant goes in the bathroom.
CONTINUED ON LIC809C
SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Laura Villanueva
LICENSING EVALUATOR SIGNATURE: DATE: 05/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/14/2024
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 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: GONZALEZ FCC AKA LULU DAY CARE
FACILITY NUMBER: 566215609
VISIT DATE: 05/14/2024
NARRATIVE
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LPA informed Licensee that the bathroom door can be closed to keep the infant out. Licensee took the child safety locks off the bathroom and the bedroom doors in the presence of LPA.

LPA reminded Licensee that the areas where child care children have access are to be free of hazards and toxins. Licensee stated that she will clean the area today.

Licensee's assistant arrived while LPA was present. LPA issued a Type A deficiency for the adult not fingerprinted in the home. Today, deficiencies cited under Title 22 Division 12. Appeal rights given.

Upon receipt of this report, licensee shall post and provide copies of this licensing report to parents /guardian of children in care at the facility and to parent/guardians of children newly enrolled at the facility during the next 12 months. Licensee to provide LIC 9224 for each child in care and have each parent sign the form that they have received a copy of the report LIC 809 and LIC 809 D.

THIS REPORT MUST BE FILED IN FACILITY FILE AND MADE AVAILABLE FOR PUBLIC REVIEW FOR 3 YEARS.

Exit interview conducted in Spanish with Licensee, Blanca Gonzalez and a copy of this report was given along with Appeal rights.

SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Laura Villanueva
LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2024
LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 05/14/2024 04:38 PM - It Cannot Be Edited

Document is an Amendment of Original Document on 05/14/2024 04:16 PM


Citations on this Visit Report are Under Appeal!


Created By: Laura Villanueva On 05/14/2024 at 01:19 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: GONZALEZ FCC AKA LULU DAY CARE
FACILITY NUMBER: 566215609

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/14/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Under Appeal
Type A
05/14/2024
Section Cited
HSC
102370(d)(1)

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102370 Criminal Record Clearance-All individuals subject to a criminal record review shall obtain a criminal record clearance or exemption prior to working, residing or volunteering in a licensed home. (1) Obtain a California clearance or a criminal record
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LPA provided LIC9163 for daughter to have fingerprints taken. Licensee will send the completed form via email to: laura.villanueva@dss.ca.gov.
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exemption as required by the Department. This requirement was not met as evidenced by: Licensee's daughter, Blanca Jazmin Gonzalez was present and caring for child care children without a criminal record clearance. This poses an immediate threat to children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:George Mingle
LICENSING EVALUATOR NAME:Laura Villanueva
LICENSING EVALUATOR SIGNATURE:
DATE: 05/14/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/14/2024


LIC809 (FAS) - (06/04)
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