198021106-3-21-2024-33-CC-VMGA-D3KNJB-20240321103004

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198021106
Report Date: 03/21/2024
Date Signed: 03/21/2024 10:30:08 AM

Document Has Been Signed on 03/21/2024 10:30 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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	GOMEZ & CRUZ FAMILY CHILD CARE		FACILITY NUMBER:	198021106
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 3	DATE:	03/21/2024
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Licensee Maria Gomez		TIME COMPLETED:	10:45 AM

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This inspection was conducted in Spanish.

Licensing Program Analyst (LPA) Veronica Martinez Garza conducted a case management - licensee initiated inspection at the above facility on 03/21/24 at 08:30 a.m. The home is currently licensed for 8 children and a request for a capacity of 14 children was received. All areas identified in the facility sketch were toured. There were 03 children present during this inspection. Operation hours are Monday - Saturday from 04:30 a.m. – 10:00 p.m.

LPA inspected the facility and found the facility to be clean and safe. The day care area is provided in the living room, kitchen, dining room, bedroom next to the dining room, and rear yard. Areas off limits to children and parents include: 2 bedrooms, 1 bathroom, detached garage, and back half of rear yard (where 4 dogs are located). The bedrooms, bathroom, detached garage and back half of rear yard are inaccessible by locked doors. Licensee keeps all keys inaccessible to children in care. LPA observed cribs and cots in the bedroom. Napping equipment meets Title 22 Regulations. Per Licensee, food is provided to all children in care. The home maintains telephone service via a cell phone and remains in the facility during operation hours. LPA observed ventilation and heating.

Detergents, cleaning compounds, medications, and other items which could pose a danger to children were observed to be inaccessible to children. Per Licensee, there are no poisons in the home and understands that storage areas for poisons must be locked with a key or combination lock. At 08:46 a.m., smoke and carbon monoxide detectors were tested and are operable. The valve on the required 2A 10BC fire extinguisher indicates fully charged and was purchased on 12/17/23, as indicated on the attached receipt.

The licensee has a first aid kit readily available. Per Licensee, there are no firearms or weapons stored in the home. LPA observed the required posted documentation in the living room. LPA reviewed facility records for LIC 9040- Facility Roster and Disaster drill log. The last disaster drill documented was 02/07/24.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE:	DATE: 03/21/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2024

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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: GOMEZ & CRUZ FAMILY CHILD CARE	FACILITY NUMBER: 198021106
	VISIT DATE: 03/21/2024

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Currently will use the back yard for outdoor play with adequate shade and age-appropriate play equipment for children in care. LPA did not observe any objects that could be hazardous to children in care. Licensee understand that children should be supervised at all times. LPA did not observe any pools, spas, hot tubs, fishponds, or similar bodies of water during the inspection.

LPA reviewed Licensee’s Pediatric First Aid and CPR certification, expires 09/18/24 and current Mandated Reporter Training expires 09/02/24.

Per Licensee, the co-licensee will be her assistant. Co-licensee's Pediatric First Aid and CPR certification, expires 09/18/24 and current Mandated Reporter Training expires 09/04/24.

The facility has requested an increase of capacity from 8 to 14 on 02/20/24. Fire clearance was granted on 03/12/24. The licensee provided proof of control of property. License will be amended to reflect new capacity of fourteen (14) children. The increase is contingent upon a Licensing Program Manager review and approval.

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

Exit interview conducted and report was reviewed with the Licensee Maria Gomez.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE:	DATE: 03/21/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2024

LIC809 (FAS) - (06/04)

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