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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197418077
Report Date: 01/18/2022
Date Signed: 01/18/2022 04:11:37 PM

Document Has Been Signed on 01/18/2022 04:11 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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:GONZALEZ FAMILY CHILD CAREFACILITY NUMBER:
197418077
ADMINISTRATOR:GONZALEZ, CELIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 977-9264
CITY:LAWNDALESTATE: CAZIP CODE:
90260
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 3DATE:
01/18/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:02 PM
MET WITH:Celia GonzalezTIME COMPLETED:
03:00 PM
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On 1/18/2022 Licensing Program Analyst (LPA),Judy Laureano conducted an unannounced Annual Required Inspection and was met by Celia Gonzalez, licensee . Also present were Staff #1 (S1) and Staff #2 (2). Licensee is Spanish Speaking. Days and hours of operation are Monday through Friday from 6:30 a.m. to 6:30 p.m.

LPA toured the home inside and outside and a census was taken, LPA observed 3 children and licensee confirmed that 9 children are currently enrolled. Current facility sketch reviewed, and Licensee confirmed that daycare services are being provided in the backroom/ day care room and children use the adjacent bathroom. Licensee confirmed that Bedroom 1 is being used for isolation purposes when a child is sick. Living room and dining room area are used for eating and extra space for day care purposes. Kitchen, hallway and bedroom 2 and additional bathroom are OFF LIMITS to the children in care. There is no swimming pool or other bodies of water on the premises. There are no firearms or ammunition on the premises. No poisons were observed during the inspection. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible.

Open face heaters in the home was barricaded and made in accessible to the children in care. There is a working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort. There are no stairs in this home. Safe toys and play equipment were observed. The home has working telephone service and LPA confirmed the phone number is 323 252-1071

LPA did not observed any infants in care. LPA discussed Safe Sleep Regulations with licensee and assistant. There is one crib and/or a play yard for each infant in care, cribs and play yards are kept free from all loose articles and objects while infants are sleeping,
SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE: DATE: 01/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/18/2022
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 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: GONZALEZ FAMILY CHILD CARE
FACILITY NUMBER: 197418077
VISIT DATE: 01/18/2022
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and there are no objects hanging above or attached to the crib or play yard. Infants are not swaddled while in care. Provider physically checks on sleeping infants every fifteen minutes and documents any signs of distress which includes but is not limited to flushed skin color, increase in body temperature, restlessness and labored breathing. Infants can be visually observed through an open door if sleeping in a separate room. Individual Infant Sleeping Plan is completed and in file for each infant up to 12 months of age. Infants up to 12 months of age are placed on their backs for sleeping.

Licensee ensures that children in care are supervised at all times and is aware children shall not be left in parked vehicles. Car seats are used for transportation purposes only and are not used for sleeping children. The outdoor play area in the backyard is fenced and there are no hazards to children present. Capacity as specified on the license is being maintained.

LPA reviewed a sample of children’s files and observed files were complete with emergency information as required. One file out of three was missing the Parent Rights form. LPA provided the LIC311 to licensee for reference. Licensee’s Mandated Reporter Training was completed, date unavailable. Licensee’s pediatric CPR/First Aid was taken on 10/25/2021. A review of records indicates that all employees and/or volunteers have immunization records on file for influenza, pertussis and measles. LPA advised licensee to create files for all assistant to retrieve necessary documents for CCL.
All adults who reside or work in the home have a criminal record clearance or exemption. There are no excluded individuals present at this home.

Incidental Medical Services (IMS) are not currently being provided. Licensee is aware that
an IMS plan is required to be submitted to the licensing office if they provide any of these services. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.
SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:

DATE: 01/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/18/2022
LIC809 (FAS) - (06/04)
Page: 2 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: GONZALEZ FAMILY CHILD CARE
FACILITY NUMBER: 197418077
VISIT DATE: 01/18/2022
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LPA and Licensee discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies are cited.

This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.
SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:

DATE: 01/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/18/2022
LIC809 (FAS) - (06/04)
Page: 3 of 6