197416032-12-5-2025-58-CC-ECAO-DP3TDZ-20251205133909

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197416032
Report Date: 12/05/2025
Date Signed: 12/05/2025 01:39:28 PM

Document Has Been Signed on 12/05/2025 01:39 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	GONZALEZ FAMILY CHILD CARE		FACILITY NUMBER:	197416032
ADMINISTRATOR/ DIRECTOR:	GONZALEZ, JOAQUINA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 892-8169
CITY:	GRANADA HILLS	STATE: CA	ZIP CODE:	91344
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 3	DATE:	12/05/2025
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	07:35 AM
MET WITH:	Joaquina Gonzalez, Licensee		TIME VISIT/ INSPECTION COMPLETED:	11:30 AM

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On 12/05/2025, Licensing Program Analysts (LPAs) Elicia Calvillo and Nathanael John Mooberry conducted an unannounced Annual 3 Year inspection at 16250 Devonshire Street, Granada Hills, CA. 91344. LPAs arrived at the facility at 07:35AM, identified self and met with Joaquina Gonzalez, Licensee who guided analysts on a tour of the inside and outside of the facility. There were 3 children present at the time of arrival. LPAs provided Licensee with a copy of the LIC125 Entrance Checklist -Family Child Care Homes to help facilitate the inspection. Licensee cares for children from ages newborn to 13 years. Facility hours of operation are Monday to Saturday from 06:30AM to 10:00PM.

The family child care home is a one-story dwelling which includes a living room, dining room, kitchen, 2 bathrooms, 3 bedrooms, and attached garage. There is a fenced front yard and a fenced back yard.

There is a fenced front yard that is used for dropping off and picking up children. There is an outdoor play area is located at the front yard of the house. LPAs observed that the outdoor play yard ground is covered with cement and artificial grass, there is adequate shade, and there are toys and materials appropriate for the ages of the children. There is a second play yard in the back yard of the house.

All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. The children use the living room for child care activities and eating. LPAs observed there are tables and chairs, toys and play items that are safe, clean, and appropriate for children’s ages.

The children use bedroom #1/bedroom #2 for child care activities, learning activities, and sleeping. LPAs observed there are tables, chairs, toys, cots with bed lines, cribs, and other play items that are safe, clean, and appropriate for children’s ages.

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NAME OF LICENSING PROGRAM MANAGER: Rita Ramos
NAME OF LICENSING PROGRAM ANALYST: Elicia Calvillo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 12/05/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2025

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: GONZALEZ FAMILY CHILD CARE	FACILITY NUMBER: 197416032
	VISIT DATE: 12/05/2025

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The children use bathroom #1 located in bedroom #1/bedroom #2 and bathroom #2 in the hallway near the living room. Both bathroom vanity cabinets hold hand soap and paper products, and no hazards were observed. LPAs observed that both bathrooms that children use are safe and sanitary.

Per Licensee, when a child shows signs of illness they will be separated from other children and isolated in the living room, bedroom #1/bedroom #2 which ever one is available and away from the other children.

The kitchen is made inaccessible with the use of child proof gate blocking the only entrance. The Licensee provides food for children in care. Licensee stated when food is brought to the facility it is labeled with child’s name and is stored properly. There is telephone service via a land line and a cellphone.

Per Licensee, areas off limits to children and parents include bedroom #3, kitchen, garage and are made inaccessible by use of child proof door knobs, latches, and door locks.

Per Licensee, there are no firearms, or ammunition on the premises. LPAs did not observe any firearms or ammunition during the inspection. Poisons, detergents, cleaning compounds, medicines, firearms, and other items which could pose a danger if readily available to children are stored where they are inaccessible to children. Per Licensee, there are poisons on the premises and LPAs observed they are locked in a cabinet in the garage.

Per Licensee, there are no pets on the premises. LPAs did not observe any pets on the premises. LPAs did not observe any pools, spas, hot tubs, fish ponds, or similar bodies of water during the inspection. LPAs did observe a 100 gallon fish tank located in the kitchen, that is made inaccessible with the use of a child proof gate.

LPAs did observe a fireplace and is made inaccessible to children with the use of a metal gate and a glass enclosure. LPAs did not observe any open face heaters during the inspection. There is a working fire extinguisher, the valve on the 3A 40BC fire extinguisher indicates fully charged and Licensee confirmed the last service date was 05/08/2025. There is a combination smoke alarm via a device attached to the wall that the Licensee confirms is a fire alarm. There is a carbon monoxide detector located in the living room and was tested and is operable.

LPAs did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer

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NAME OF LICENSING PROGRAM MANAGER: Rita Ramos
NAME OF LICENSING PROGRAM ANALYST: Elicia Calvillo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 12/05/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2025

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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: GONZALEZ FAMILY CHILD CARE	FACILITY NUMBER: 197416032
	VISIT DATE: 12/05/2025

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Chairs, Trampolines and/or any other item that fall into these categories are not permitted in a family child care facility.

Licensee was reminded that children in care are to be supervised at all times and made aware that children shall not be left in parked vehicles. Car seats shall only be used for transportation purposes and shall not be used for sleeping.

Capacity as specified on the license is being maintained.

Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted.

LPA reviewed a sample of children’s records and observed that 2 files were missing the medical consent form records and documented on the LIC857.

An emergency fire/disaster drill has been completed and documented within the last 6 months on 11/20/2025. Licensee’s Mandated Reporter Training was completed on 10/09/2025. Licensee’s pediatric CPR/First Aid expires on 07/2027.

LPA reviewed three (3) personnel records and observed that the files were complete and documented on LIC 859.

LPA reviewed with the 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.

Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.

The Licensee was reminded that all adults 18 and over living or working in the home, 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
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NAME OF LICENSING PROGRAM MANAGER: Rita Ramos
NAME OF LICENSING PROGRAM ANALYST: Elicia Calvillo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 12/05/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2025

LIC809 (FAS) - (06/04)

Page: 4 of 5

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: GONZALEZ FAMILY CHILD CARE	FACILITY NUMBER: 197416032
	VISIT DATE: 12/05/2025

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penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated

There are currently one (1) infant in care. LPAs 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. LPAs also informed Licensee of the importance of checking for and removing any 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.

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)/ (800) 514- 0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, there are no citations being cited today.

During the exit interview, the Licensee, confirmed that there are no Registered Sex Offenders living in the facility and LPAs completed the RSO profile in FAS.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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.

A notice of site visit was given and must remain posted for 30 days.
Exit interview conducted and report was reviewed with the Licensee Joaquina Gonzalez.
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NAME OF LICENSING PROGRAM MANAGER: Rita Ramos
NAME OF LICENSING PROGRAM ANALYST: Elicia Calvillo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 12/05/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2025

LIC809 (FAS) - (06/04)

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