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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020130
Report Date: 05/15/2024
Date Signed: 05/15/2024 11:39:42 AM

Document Has Been Signed on 05/15/2024 11:39 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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:GONZALEZ FAMILY CHILD CAREFACILITY NUMBER:
198020130
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: DATE:
05/15/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Licensee Amelia GonzalezTIME VISIT/
INSPECTION COMPLETED:
12:00 PM
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(Read to Licensee in Spanish)
Licensing Program Analysts (LPAs) Jeanette Estrada and Jonnisha Culbert conducted an unannounced annual inspection to the above facility. The facility is also being evaluated for a capacity increase during this inspection. An approved fire clearance was approved on 04/18/24. LPAs arrived at the facility at 9:30AM and met with Amelia Gonzalez, Licensee who guided analyst on a tour of the facility. Per Licensee, there are eight children that are currently enrolled. A current children’s roster was available for review. There were two children present upon arrival. At 10:47AM one more child arrived. All residents have been verified and adults have a criminal record clearance.
This is a one-story home which consists of 3 bedrooms, 2 bathrooms, kitchen, dining room, living room, front yard and backyard (fenced). Per Licensee, on limits areas consist of living room, kitchen, hallway bathroom, dining room, front and back yard. Off limits areas are all bedrooms, 1 bathroom, detached garage. LPAs observed that there is a screened fireplace in the living room. Per Licensee, the fireplace is only used to display decorations. LPAs observed decorations displayed in the covered fireplace.
The licensee provides food for children in care. Licensee states that there are no firearms stored in the home.
All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. There is telephone service via a cellphone that is used and the cellphone stays at the facility during operation hours. There is ventilation and heating; Licensee has an A/C wall unit installed in the living room. The wall heater is not in use, the pilot on the wall heater is locked. Heating is provided by a portable heater. Safe toys play equipment and materials were observed.
Detergents, cleaning compounds, medications, and other items which could pose a danger to children were observed to be inaccessible to children. Detergents are kept outside in the laundry room, cleaning compounds are kept in a latched cabinet under the sink. Medications and knives are kept in an upper cabinet in the kitchen. Although the kitchen is on limits, there is a safety gate at the entrance from the living room.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE: DATE: 05/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/15/2024
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 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: GONZALEZ FAMILY CHILD CARE
FACILITY NUMBER: 198020130
VISIT DATE: 05/15/2024
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Per Licensee, children only use the dining room which is connected to the kitchen for eating and homework. The licensee states that there are no poisons in the home and understands that storage areas for poisons must be locked with a key or combination lock. The restroom that children use was observed to be safe and sanitary.
LPAs observed 2A10BC fire extinguisher. Per License, extinguisher was checked during fire clearance inspection 04/18/2024. During LPAs observed that fire detector and carbon monoxide detector are located in the living room and they both work properly.
Currently, children are using the front yard and the back yard for outdoor play time. The outdoor play area was observed to be fenced. LPAs observed that the outdoor yard has toys and other materials for children to play with. LPAs did not observe any objects that can pose a danger to children on the outdoor yard. The licensee states that supervision is always provided.
The licensee has completed training on preventive health practices including Pediatric First Aid and CPR. The licensee's Pediatric First Aid and CPR expires on 08/05/2025 and Mandated Reported expires on 03/12/2026. Licensee has proof of immunization for measles, pertussis, and flu. All adults residing in the home has required TB clearance. There are first aid supplies available in a cabinet in the dining room. LPA advised that if a child shows signs of illness they shall be separated from other children. Licensee stated a portion of the living room is used as the isolation area. Per Licensee there are no pets in the home.
Licensee states that she is not currently caring for infants. Licensee states that if an infant is enrolled, the infant will sleep in the living room where they are constantly supervised.
Currently Licensee does not have infants enrolled. LPA discussed the safe sleep regulations with the Licensee 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. Licensee 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 clearance or exemption, prior to 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.
LPAs 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.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:

DATE: 05/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2024
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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: GONZALEZ FAMILY CHILD CARE
FACILITY NUMBER: 198020130
VISIT DATE: 05/15/2024
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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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 Center and the ADA, available at: http://www.ada.gov/childqanda.htm
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.
During the exit interview, the Licensee Amelia Gonzalez confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO in FAS.

A large license would be issued upon the department's approval.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site inspection by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

Exit interview was conducted and report reviewed with the Licensee, Amelia Gonzalez.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:

DATE: 05/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2024
LIC809 (FAS) - (06/04)
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