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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198401091
Report Date: 09/17/2024
Date Signed: 09/18/2024 04:36:15 PM

Document Has Been Signed on 09/18/2024 04:36 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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:GONZALEZ FAMILY CHILD CAREFACILITY NUMBER:
198401091
ADMINISTRATOR/
DIRECTOR:
GONZALEZ, JOSEFINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 608-5354
CITY:BELLFLOWERSTATE: CAZIP CODE:
90706
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: DATE:
09/17/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Josefina Gonzalez, ApplicantTIME VISIT/
INSPECTION COMPLETED:
11:30 AM
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On 9/17/24 Licensing Program Analysts (LPAs) Alicia Mooberry and Keneisha Dunlap conducted a pre-licensing inspection for the above address. LPA met with Josefina Gonzalez, Licensee/Applicant, who guided LPAs on a tour of the facility. Individuals residing in the home were discussed and noted. Per Applicant, hours of operation will be Monday - Friday, 7:00 am to 6:00 pm.

This is a one-story home which consists of 3 bedrooms, 2 bathroom, den (Daycare Room), kitchen, front and backyard (fenced) and converted garage located in the back yard. The home was inspected for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children in care.

Areas used by children include: Living Room, Den (Daycare Room), bathroom (off of the living room and inside bedroom 1), enclosed play area in the back yard.

Areas off limits include: Bedroom 1, Bedroom 2 and 3, 1 bathroom, converted garage, kitchen, backyard. The kitchen is made inaccessible by a safety gate. Bedroom 1 will be made in accessible by adding a safety gate between the bathroom and bedroom. Knives and other sharp utensils will be located in overhead cabinet in the kitchen. Cleaning products were located in cabinets locked with safety latches under the sink in kitchen and bathroom and in the overhead shelves in the laundry room. There are outlet covers throughout the home. Smoke detectors and carbon monoxide detector were observed, tested and found to be operable.

The home was observed to be clean and orderly. LPA observed age appropriate toys and learning materials in the daycare area. First Aid and emergency supplies are available located in the daycare room.

LPA observed the required 2A10 BC fire extinguisher in the daycare room, with service tag dated 8/27/24. Applicant was reminded that fire extinguishers need to be purchased or serviced yearly. The applicant will use fans and a portable air conditioner to maintain home comfortable. The home has central heating. -------------PAGE 1

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE: DATE: 09/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/17/2024
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 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: GONZALEZ FAMILY CHILD CARE
FACILITY NUMBER: 198401091
VISIT DATE: 09/17/2024
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The applicant states that meals will be provided by facility and parents will also have the option to bring food from home. Applicant was informed that any food brought from the children’s homes must be labeled with child’s name and properly stored or refrigerated.

The applicant has completed the required Health and Safety Training, Nutrition, and Lead Training, Mandated Reporter Training and Pediatric First Aid/CPR. Required immunization's are current.

Per Applicant, there are no weapons or firearms in the facility,


LPAs observed an enclosed and shaded area in the backyard that will be used for outdoor play. The surface is covered with artificial turf and has age appropriate toys. The area us enclosed by wooden picket fencing. The converted garage in the back yard was observed to be locked and is utilized for storage. There are no bodies of water on the premises.

LPA reviewed with applicant 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. Entrance Checklist was provided to the applicant.

Children will nap in daycare room, mats and a play yard are available.

LPA discussed the safe sleep regulations with applicant 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.


LPA also informed applicant 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.

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: http://www.ada.gov/childqanda.htm
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SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:

DATE: 09/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2024
LIC809 (FAS) - (06/04)
Page: 2 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: GONZALEZ FAMILY CHILD CARE
FACILITY NUMBER: 198401091
VISIT DATE: 09/17/2024
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Per applicant personal items will be placed in an individual cubby. Children will bring their own blanket and sheet for nap. Bedding will be washed weekly or as needed.

The isolation area for a sick child waiting to be picked up will be in the living room next to the exit away from other children.



The following was discussed with the applicant:

Applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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.

-In the absence of the licensee a qualified adult must be present supervising the children; a qualified adult is an individual who has a valid and current adult/infant CPR & Pediatric First Aid certification, TB clearance, immunization, Mandated Reporter training certificate www.mandatedreporterca.gov, and a valid criminal record clearance associated to the facility license.

-A current roster of children enrolled must be available and maintained for a period of three years, even after children are no longer attending the facility.



-Unusual incident or any changes will be reported to Licensing within 24 hours and an LIC 624B will be submitted within 7 days.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.

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SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:

DATE: 09/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2024
LIC809 (FAS) - (06/04)
Page: 3 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: GONZALEZ FAMILY CHILD CARE
FACILITY NUMBER: 198401091
VISIT DATE: 09/17/2024
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To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

On this date, 9/11/24, the California Attorney General - Megan’s Law website was searched


for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

Per applicant, there are no dual licenses at this address. Applicant’s email address was obtained during this inspection. The applicant was advised that email may be public information.



The following corrections need to be made prior to obtaining a small family child care license.
Proof of corrections are due by Monday 9/23/24
1. Applicant will add a safety gate outside of bathroom leading to bedroom.
2. Applicant will fix the play yard area ground where there were uneven surface. The picket fence will be fixed

A small family childcare license will be granted upon completion of all required documentation and corrections. Once licensed, the applicant is required to comply with the terms and limitations stated on the license.

Exit interview conducted and report was reviewed with Josefina Gonzalez, Applicant

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:

DATE: 09/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2024
LIC809 (FAS) - (06/04)
Page: 4 of 4