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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566217370
Report Date: 03/13/2025
Date Signed: 03/13/2025 11:40:56 AM

Document Has Been Signed on 03/13/2025 11:40 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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:GONZALEZ FAMILY CHILD CAREFACILITY NUMBER:
566217370
ADMINISTRATOR/
DIRECTOR:
FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 3DATE:
03/13/2025
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:50 AM
MET WITH:Adelina GonzalezTIME VISIT/
INSPECTION COMPLETED:
11:45 AM
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On March 13, 2025 at 9:50 AM, Licensing Program Analyst (LPA) Laura Carone conducted an announced Pre-licensing inspection. Licensee has submitted a change of location application. Previous address licensee number 566216820. LPA informed the licensee the purpose of the inspection and together toured the facility inside and outside. Licensee caring for 3 of her own children at the time of the inspection. Licensee stated childcare will be provided Monday thru Saturday 6:30AM to 5:30PM.

The home is a 4- bedroom, )-bath, single home. The licensee will use the living room, kitchen, hall bathroom, and backyard for the childcare. Inaccessible areas will be the garage, 4-bedrooms, 1-bathroom and as listed in facility sketch as designated area off limits for childcare. The backyard is fully enclosed with a fenced wall. LPA did not observe any toxins/hazardous items accessible to children in the facility today. Cleaning agents and disinfectants are stored in the garage making them inaccessible. Kitchen knives are stored out of reach of children. The bathroom to be used for children in care was observed to be clean and free of toxins/hazardous items accessible to children. A small dog is in the home with current immunizations.

A regulation 2A10BC fire extinguisher was observed with a purchase date of 01/04/2025. Licensee is reminded to service or purchase the fire extinguisher yearly. The City Oxnard Fire Department inspected and tested smoke and carbon monoxide detectors in the home on 03/12/2025 which were found operational. All adults in the home are fingerprint cleared. LPA observed the home to be orderly. No bodies of water were observed on site. Licensee stated that there are no guns or ammunition in the home.

Licensee's Pediatric First Aid/CPR certificate is valid until 07/02/2025. Licensee's Mandated Reported Continued on LIC809-C

SUPERVISORS NAME: Susana Martinez
LICENSING EVALUATOR NAME: Laura Carone
LICENSING EVALUATOR SIGNATURE: DATE: 03/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/13/2025
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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: GONZALEZ FAMILY CHILD CARE
FACILITY NUMBER: 566217370
VISIT DATE: 03/13/2025
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Training is valid until 04/11/2025. Licensee provided proof of control of property with a rental agreement and submitted a signed Landlord Consent Form LIC9149.

Licensee 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.

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 licensee 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.

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 discussed and provided Guidelines to Safe Sleep and Effects of Lead Exposure leaflets. Licensee was provided information from PIN 20-24-CCP - Recently Approved Safe Sleep Regulations In Effect and LIC 9227 (Infant Sleeping Plan). Licensee was informed baby walkers, jumpers, bouncers, exersaucers, or any similar article are not permitted on the premises during day care hours. Licensee was made aware of the responsibility to know the regulations for Family Child Care

Continued on LIC809-C

SUPERVISORS NAME: Susana Martinez
LICENSING EVALUATOR NAME: Laura Carone
LICENSING EVALUATOR SIGNATURE:

DATE: 03/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2025
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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: GONZALEZ FAMILY CHILD CARE
FACILITY NUMBER: 566217370
VISIT DATE: 03/13/2025
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Home which can be accessed on-line at www.ccld.ca.gov.

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/inspection-process.

On this date, March 13, 2025, 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.

Licensee, 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. 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.

A small family child care license for a capacity of 8 children is effective today, March 13, 2025.

Exit interview conducted and report was reviewed with the licensee, Adelina Gonzalez.

SUPERVISORS NAME: Susana Martinez
LICENSING EVALUATOR NAME: Laura Carone
LICENSING EVALUATOR SIGNATURE:

DATE: 03/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2025
LIC809 (FAS) - (06/04)
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