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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198004958
Report Date: 02/28/2025
Date Signed: 02/28/2025 02:06:26 PM

Document Has Been Signed on 02/28/2025 02:06 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:GONZALEZ FAMILY CHILD CAREFACILITY NUMBER:
198004958
ADMINISTRATOR/
DIRECTOR:		GONZALEZ, REYNALDAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 372-0118
CITY:PASADENASTATE: CAZIP CODE:
91104
CAPACITY: 14TOTAL ENROLLED CHILDREN: 2CENSUS: 1DATE:
02/28/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:20 PM
MET WITH:Licensee Reynalda GonzalezTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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On 2/28/25 at 12:20pm, Licensing Program Analysts (LPA)s Stephanie Li and Mary Silva conducted an unannounced annual inspection to the above facility. A risk assessment was conducted upon entry. LPA’s met with Licensee Reynalda Gonzalez, who led LPA’s on a tour of the facility. There was 1 child and 1 adult present upon arrival. Per Licensee, there is currently 2 children enrolled. A current children’s roster was not available for review. Licensee complete roster during today’s visit. Licensee is Spanish speaking and visit was conducted in Spanish by LPA Mary Silva.

This is a one-story home which consists of 4 bedrooms, 2 bathrooms, living room, dining room, kitchen, attic, basement, laundry room, backyard (fenced) and back house (single unit with tenants on roster). The children use the bathroom in the hallway, living room, dining room, kitchen, and nap/play room. Per licensee, areas off limits to children and parents include: 3 bedrooms, 1 bathroom, and back house and sheds. Hours of operation is from Monday – Friday 7:00am-5:00pm.

All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness.

The following was observed and reviewed during this inspection. Cleaning compounds, and medications were observed to be inaccessible to children. Per licensee, there are no poisons kept in the home. The restroom that children use was observed to be safe and sanitary. LPA’s advised to store hazardous items ie. razors, shavers, pocket knives, etc in locked cabinets or drawers so that they are inaccessible to children. There is telephone service via cellphone that stays at the facility during operation hours. The home is observed to be clean and orderly with central ac unit and heat. LPA’s observed covers taped to all vents inside the home. Per licensee, she is cleaning the attic and covered the vents to prevent ash and debris from entering the rooms. There are toys available for children. Licensee has cots for napping children. There are first aid supplies available. Page 1 of 4
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Stephanie Li
LICENSING EVALUATOR SIGNATURE: DATE: 02/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/28/2025
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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: GONZALEZ FAMILY CHILD CARE
FACILITY NUMBER: 198004958
VISIT DATE: 02/28/2025
NARRATIVE
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LPA’s observed the following required posted documentation in the dining room: Facility License, (LIC) 9148- Earthquake Preparedness form, Publication (PUB) 394- Notification of Parent Rights, and LIC610- Emergency Disaster Plan.

At 1:00pm, LPA’s observed the required 2A 10BC fire extinguisher last serviced on 3/2023. LPA’s advised licensee that fire extinguisher needs to be serviced every year or purchased every year and retain the receipt. Smoke and carbon monoxide detectors were tested and are operable. All homes shall conduct fire and disaster drills at least once every six months, and document the date and time of each drill. Per licensee, she has not conducted a drill for over a year. A deficiency is being issued. See page LIC809D. Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.

Currently, children are using the back yard for outdoor play time. The outdoor play area was observed to be fenced. LPA’s observed the outdoor yard to have appropriate toys and other materials for children to use. LPA’s observed a small dog in the yard. Per licensee, the dog does not bite and listens well and she puts him in his kennel when the children come out to play. LPA’s observed dog food and advised to place the dog food bowl inside the kennel or out of reach of children when they go out to play. LPA’s also observed dog feces in the grass and advised for licensee to check and clean for dog feces before children play in the back yard. LPA’s also observed metal rain gutters along side a wall. Per licensee, those are new as the winds blew off their old rain gutters and new ones will be installed this weekend. There is a back single house with 2 tenants. Tenants are on the licensee roster. The licensee is observed to be operating within the license capacity limitations.

At 1:45 pm, children and adults records were reviewed, including emergency information and documented on LIC857. Licensee has completed CPR/First Aid training online through American COR care association (exp 3/2026) CPR is trainers are not EMSA approved. LPA’s advised that CPR/First Aid needs to be completed with EMSA approved trainers. Deficiency is being issued, see LIC809D page. Licensee is also missing new Mandated Reporter AB 1207 Training Certificate. Last certificate expired on 12/2023. Deficiency is being issued. See LIC809D page. LPA’s observed licensee does not have a sleep log check for infant in care. Per licensee, she checks on them regularly but has not been logging it. A technical violation is being issued. LPA’s reviewed safe sleep regulations with licensee and reminded that the play pen needs to be empty of toys and blankets when infant are napping. Page 2 of 4
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Stephanie Li
LICENSING EVALUATOR SIGNATURE:

DATE: 02/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2025
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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: GONZALEZ FAMILY CHILD CARE
FACILITY NUMBER: 198004958
VISIT DATE: 02/28/2025
NARRATIVE
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Licensee stated IMS is not being provided at this time. 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/.

LPA discussed the safe sleep regulations and discussed the Child Care Licensing Safe Sleep webpage at http://www.cdss.ca.gov/inforescources/child-care-licensing/public-information-and-resoucrces/safe-sleep as an additional resource. LPA also informed applicant/licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at http://www/cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment. Safe sleep guide from CDSS provided in Spanish and reviewed by LPA Joanne Solorio-Campos in Spanish. Required infant forms were provided and reviewed for future infant enrollment.

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

Megan’s Law - Family Child Care Homes During the exit interview, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

LPA advised the licensee to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov



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SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Stephanie Li
LICENSING EVALUATOR SIGNATURE:

DATE: 02/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2025
LIC809 (FAS) - (06/04)
Page: 3 of 7
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: GONZALEZ FAMILY CHILD CARE
FACILITY NUMBER: 198004958
VISIT DATE: 02/28/2025
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MyChildCarePlan.org – Centers and Family Child Care Homes Licensee was informed of the
MyChildCarePlan.org website; 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

Based on Licensing staff observations and records review, the following deficiencies listed on the attached LIC 809D (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health and safety. A technical violation is being issued, see page LIC9102.


A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with Licensee Reynalda Gonzalez.



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SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Stephanie Li
LICENSING EVALUATOR SIGNATURE:

DATE: 02/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2025
LIC809 (FAS) - (06/04)
Page: 4 of 7
Document Has Been Signed on 02/28/2025 02:06 PM - It Cannot Be Edited


Created By: Stephanie Li On 02/28/2025 at 01:35 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
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: GONZALEZ FAMILY CHILD CARE
FACILITY NUMBER: 198004958

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/28/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(9)(A)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (9) Each family child care home shall have a written disaster plan of action prepared on a form approved by the Department. All children, age and ability permitting, and the provider, the assistant provider, and other members of the household, shall be instructed in their duties under the disaster plan. As their age and ability permit, newly enrolled children shall be informed promptly of their duties as required in the plan. (A) Each family child care home shall conduct fire drills and disaster drills at least once every six months.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and record review, the licensee did not comply with the section cited above in licensee has not conducted fire drill in over a year, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/07/2025
Plan of Correction
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Per licensee, she will conduct drill with children on Monday 3/3/25 and send drill log to LPA via email or text by 3/7/25.
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and record review, the licensee did not comply with the section cited above in licensees mandated reporter certificate expired 12/2023 and has not completed renewed training, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/14/2025
Plan of Correction
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Per licensee, she is going to contact her Union to complete the renewed training or completed it online with the website LPA's provided and submit new certificate to LPA by 3/14/25.
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:Christina Gabelman
LICENSING EVALUATOR NAME:Stephanie Li
LICENSING EVALUATOR SIGNATURE:
DATE: 02/28/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/28/2025


LIC809 (FAS) - (06/04)
Page: 5 of 7
Document Has Been Signed on 02/28/2025 02:06 PM - It Cannot Be Edited


Created By: Stephanie Li On 02/28/2025 at 01:35 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
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: GONZALEZ FAMILY CHILD CARE
FACILITY NUMBER: 198004958

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/28/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416(c)
Personnel Requirements
(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and record review, the licensee did not comply with the section cited above in licensee does not have EMSA approved CPR certificate, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/30/2025
Plan of Correction
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Per licensee, she is going to contact an EMSA trainer to schedule CPR/First Aid training and will submit certificate to LPA via email or text by 4/30/25.
Type B
Section Cited
CCR
102418(g)
Immunizations
(g) The licensee shall document each child's immunizations as required by the California Code of Regulations, Title 17, Section 6070, and shall maintain such documentation for as long as the child is enrolled.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and record review, the licensee did not comply with the section cited above in one child did not have records of immunizations, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/07/2025
Plan of Correction
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Per licensee, she requested immunization records from parents during todays visit and will send proof to LPA by email or text by 3/7/2025
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:Christina Gabelman
LICENSING EVALUATOR NAME:Stephanie Li
LICENSING EVALUATOR SIGNATURE:
DATE: 02/28/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/28/2025


LIC809 (FAS) - (06/04)
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