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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197410690
Report Date: 05/06/2024
Date Signed: 05/06/2024 03:01:40 PM

Document Has Been Signed on 05/06/2024 03:01 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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:GONZALEZ-MARTINEZ FAMILY CHILD CAREFACILITY NUMBER:
197410690
ADMINISTRATOR/
DIRECTOR:		JESSI GONZALEZ-MARTINEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 947-7593
CITY:PALMDALESTATE: CAZIP CODE:
93550
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 8DATE:
05/06/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:19 PM
MET WITH:Jessi Gonzalez-Martinez, Licensee TIME VISIT/
INSPECTION COMPLETED:
03:10 PM
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On 05/06/2024, Licensing Program Analyst (LPA) Justeene Tamayo conducted an unannounced Required 1-Year inspection at the Gonzalez-Martinez Family Child Care Home. Upon arrival, the LPA met with the licensee, Jessi Gonzalez-Martinez, who guided the LPA on a tour of the facility. Family members residing in the home include 4 adults (licensee, spouse, and 2 adult daughters), and no minor children.

This is a large family childcare facility. The hours of operation are Monday through Sunday, 24 hours. During the inspection, LPA observed 8 childcare children (1 infant and 7 preschool children) with Licensee and assistant #1. Per Licensing Information System, annual facility fees were current. Incidental Medical Services (IMS) were discussed. Per the licensee, she does not have children who need IMS at this time.
The home is set up as follows: This is a two-story home with 4 bedrooms, 4 bathrooms, a kitchen, a living room, formal dining, a family room, a playroom (permit), and a garage. Parents enter the facility through the left side gate (doorbell). The home was inspected for safety, comfort, cleanliness, telephone service, central air, and heat and ventilation. The house has central heating and air conditioning. All windows have screens and are free of cracks, bugs, and debris.
Main Area: Main care is provided in playroom 1 (located in the rear of the home) and Plan room 2 (next to the kitchen). Children use the bathroom located in the playroom or another in the hallway next to the infant room.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE: DATE: 05/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/06/2024
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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: GONZALEZ-MARTINEZ FAMILY CHILD CARE
FACILITY NUMBER: 197410690
VISIT DATE: 05/06/2024
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· Stairs (For two-story hours): There is a safety gate or barricaded to make the stairs inaccessible to the children.
· The First Aid kit is in the key-locked closet, inaccessible to children. The First Aid Kit was observed to be complete with supplies and a first aid manual.
· Transportation: The licensee does provide transportation for children. The licensee has a valid California driver's license, valid vehicle insurance, and vehicle registration.
· Weapons or Firearms: Per the licensee, there are No Firearms at the facility at this time. LPA does not observe any firearms.
Documentation:
· Child files: LPA reviewed xx children's records. The records are complete.
· CPR/First Aid: LPA observed licensee has current Pediatric CPR and First Aid Training with an expiration date (03/04/2026).
· Fire Drill and Disaster Drill: Per the licensee, fire and disaster drills are conducted every 6 months; the last drill was documented and performed on 03/22/2024.
· Infant Sleeping Plan (LIC 9227) and Sleeping Log: LPA observed 2 infants have LIC 9227, and the Sleeping log is also in each infant's file.
· The licensee (does post all required information
· Mandated Reporter Training: The licensee has completed and renewed the online mandated reporter training at www.mandatedreporterca.com expires on 07/06/2025.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:

DATE: 05/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2024
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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: GONZALEZ-MARTINEZ FAMILY CHILD CARE
FACILITY NUMBER: 197410690
VISIT DATE: 05/06/2024
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· Playroom 1 and playroom 2: LPA observed age-appropriate toys and furniture for the children. LPA observed: Several small tables were observed with small chairs. Several plastic storage bins were observed in which games and toys are stored for the children. A small play kitchen was located by the door with which children could play. There are games and books on the premises of this facility.
· Children's Bathroom (#1): Children use the bathroom next to the left side of the hallway. The Bathroom was toured and inspected sink/toilet is in operable condition. The toilet and faucets are clean, safe, and operable. All poison and medications are made inaccessible to children with child safety latches on the sink cabinet and drawers. The bathroom was observed to be free and clear of hazardous items. The bathroom was clean, sanitized, and in good repair.
· Backyard: The backyard was inspected; The backyard is gated all around. Children play in the backyard. The right side has a gate with a lock. The left side has a fence. The upper backyard is not used for childcare and is off-limits for children in care. There is a barbecue island located at the upper backyard (fence) portion of the yard as well as a private entertainment room which is off-limits to children. There is a grass and concrete area for active play. There is a water fountain that is decorated only with no water hook-up. The licensee is reminded to ensure that no standing water is maintained in the water fountain. The swamp cooler unit is inaccessible to children.
· Off-limit: The areas include the home's entire upstairs and the garage. Kitchen/Dining Room. LPA observed a glass door to make the area inaccessible.
Other:
· AC/Heating Unit / Swamp Cooler unit was observed. The AC/Heating Unit is located on the right side of the home and is inaccessible to children via barrels blocking access to the AC unit. / The swamp cooler unit is inaccessible to children.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:

DATE: 05/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2024
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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: GONZALEZ-MARTINEZ FAMILY CHILD CARE
FACILITY NUMBER: 197410690
VISIT DATE: 05/06/2024
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· Bodies of water: Pre the licensee, there were no bodies of water in the home.
· Electrical outlets: All unused electrical outlets are plugged in and made inaccessible to children.
· Food: The licensee is enrolled in Food program. The licensee will provide Breakfast, lunch, and snacks, dinner. Or the food is brought from home. The containers were labeled with the children’s names and properly stored or refrigerated.
· Fire extinguisher (2A10BC): LPA observed a required fire extinguisher (2A10BC) reading in Green and located in the children's playroom, inaccessible to children. It meets standards established by the State Fire Marshall.
· Fireplace: The fireplace was observed in the living room and is screened to make it inaccessible to the children.
· Hanging window blind cords: The cords are inaccessible to children.
· Isolation area (Illness): Per the licensee, if the child shows signs of illness, they will be separated from other children and stay in the playroom 1.
· Medications and cleaning solutions: Detergents/cleaning compounds are in the upper kitchen cabinet, inaccessible to the children. Medications are in the off-limits bedroom.
· Napping: Children will nap in designated areas with adult supervision. LPA observed 10 mats in the closet.
· Overnight Care: According to the licensee does not provide overnight care.
· Pets: There is 1 dog. They have current vaccinations.
· Phone service: There is a working landline or cell phone
· Smoke Detectors and Carbon Monoxide: The smoke detectors and carbon monoxide devices tested operable.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:

DATE: 05/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2024
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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: GONZALEZ-MARTINEZ FAMILY CHILD CARE
FACILITY NUMBER: 197410690
VISIT DATE: 05/06/2024
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§ Safe Sleep: LPA discussed the safe sleep regulations with the licensee [or facility representative] and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed the 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.
§ A baby walker shall not be allowed on the premises of a family child care home in accordance with Health and Safety code sections 1596.848(b) and (c). State law prohibits baby walkers, bouncy seats, exersaucer, and other items that fall into that category.
§ Notice of Site Visit: A notice of site visit was given and must remain posted for 30 days.
§ Posting Requirements: Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
§ The regulation prohibits the smoking of tobacco in a private residence that is licensed as a family childcare home and in those areas of the family day care home where children are present (24/7 ban).
§ Licensee was advised to visit the CCL website (www.ccld.ca.gov) to obtain updates on courses and updates/changes to the regulations.
o Our Quarterly updates come out every 3 months. They are also now in Spanish. Please log in to the CCLD website, or you can email our advocates to have the quarterly updates sent directly to your email. Child Care Advocates information: www.childcareadvocatesprogram@cdss.ca.gov
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:

DATE: 05/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2024
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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: GONZALEZ-MARTINEZ FAMILY CHILD CARE
FACILITY NUMBER: 197410690
VISIT DATE: 05/06/2024
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· Staff Personnel File: LPA observed 2 staff information. The files are missing some required licensing documents (LIC 9052 and LIC 9108)
The following information was discussed with the licensee:
§ Mandatory Forms for the children's files and provider's files.
§ The licensee is reminded that 100% supervision is required for children at all times.
§ Capacity requirements, Roster requirements, and Documentation requirements for disaster drills (fire and earthquake).
§ Licensee was made aware that it is their responsibility to know the regulations and anyone who assists in providing care. Licensee was advised that the inaccessibility of hazards must be constantly reassessed depending on the children in care. Licensing must always have the facility's phone number; if the phone number is changed, licensing must be notified.
§ Licensee was advised of the requirement to report unusual incidents and injuries to the parent/guardian and Licensing within the time frame specified by the regulation and on the form LIC624B
§ The licensee was informed of the responsibility to report suspected Child Abuse by calling the Child Abuse Hotline at 1-800-540-4000. Also, call the CCL office and follow up with a written Unusual Incident/Injury Report (LIC 624B).
§ Criminal Record Statement: The licensee [or facility representative] 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 support or exemption prior to the 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.

No deficiencies have been cited at this time.

An exit interview was conducted, and a copy of this report was provided to licensee, along with a copy of her appeal rights, and Notice of Site Visit.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:

DATE: 05/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2024
LIC809 (FAS) - (06/04)
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