197700420-10-19-2021-12-CC-CBEL-C7XU7D-20211019151947

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197700420
Report Date: 10/19/2021
Date Signed: 10/19/2021 09:48:32 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/25/2021 and conducted by Evaluator Brigitte Tsutaoka

PUBLIC

COMPLAINT CONTROL NUMBER: 12-CC-20210825163021

FACILITY NAME:	VASQUEZ FAMILY CHILD CARE		FACILITY NUMBER:	197700420
ADMINISTRATOR:	THERESA DE JESUS VASQUEZ		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(747) 218-7295
CITY:	PALMDALE	STATE: CA	ZIP CODE:	93551
CAPACITY:	14	CENSUS: 2	DATE:	10/19/2021
		UNANNOUNCED	TIME BEGAN:	09:05 AM
MET WITH:	Licensee Theresa Vasquez		TIME COMPLETED:	09:55 AM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Allegation 2: Provider consumes alcohol during operating hours.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On October 19, 2021 at 9:05AM, Licensing Program Analyst (LPA) Brigitte Tsutaoka conducted an unannouced follow up complaint inspection to deliver findings on the above allegation. LPA disclosed the purpose of inspection and was granted entry by Licensee, who guided LPA on a tour of the facility. Upon entry, LPA counted 2 infants in care.
At 9:15AM, LPA observed the off-limits kitchen to be free of any alcoholic beverages.
During the course of the investigation, LPA interviewed parents and children who disclosed they had never observed the Licensee or Licensee's spouse consume alcohol during day care hours nor was any alcohol of any kind observed at the facility.
Based on evidence obtained and interviews conducted, the above allegation is deemed unsubstantiated. A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violations did or did not occur.
An exit interview was conducted, a copy of this Report, Appeal Rights, and a Notice of Site Visit were provided to the Licensee.

Unsubstantiated

Estimated Days of Completion: 60

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Brigitte Tsutaoka	TELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:	DATE: 10/19/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2021

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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