<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198004766
Report Date: 08/18/2021
Date Signed: 08/18/2021 05:34:56 PM

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:VASQUEZ FAMILY CHILD CAREFACILITY NUMBER:
198004766
ADMINISTRATOR:VASQUEZ, ZENAIDAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 233-4032
CITY:LOS ANGELESSTATE: CAZIP CODE:
90011
CAPACITY:14CENSUS: 1DATE:
08/18/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Zenaida Vasquez, Licensee TIME COMPLETED:
05:35 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Prior to entrance to the facility, LPA Mayra Rivera conducted a Covid 19 assessment and based on the licensee responses to the facility assessment questions, LPA Rivera determined safe to proceed. On Tuesday, August 18, 2021 at 2:45 PM, Licensing Program Analyst (LPA) Mayra Rivera conducted an unannounced annual inspection and met with Licensee Zenaida Vasquez who guided LPA Rivera on a tour of the facility.

During the inspection, one preschool child was present. Operating hours are Monday to Friday, 6:00 AM to 6:00 PM and care for children ages 0 to 12 years. This is a single home which consists of 3 bedrooms, 2 bathrooms, kitchen, family room (daycare room), dining room, living room (no fireplace:), backyard (fenced) and back house. The children use the kitchen, bathroom, activity/play room and backyard for daycare. There is a restroom near the activity room which the children use. Per licensee, areas off limits to children and parents include: back house (which includes 2 bedrooms or 1 bathroom), and licensee's bathroom and children's bedrooms. The LPA toured all areas used by children during this visit. Family members residing in the home was discussed with licensee and are cleared.

At 2:55 PM LPA Rivera entered the daycare room area to inspect for safety, comfort, cleanliness, ventilation and working phone (land line). For ventilation, LPA Rivera observed portable AC units and wall heater with fire proof screen protector in the living room and a wall AC unit in the daycare room. LPA observed children materials such as art supplies, puzzles, and manipulative. LPA observed the furniture and children materials to be in good condition and age appropriate.

At 3:05 PM, LPA Rivera entered the restroom and observed the toilet, running water, hand soap and paper towels. The bottom sink cabinet is used for storing toilet paper. Over the toilet storage LPA observed a lysol spray above the toilet storage. LPA advised to remove and place the lysol behind lock cabinets or an area inaccessible to children.

SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 981-3368
LICENSING EVALUATOR NAME: Mayra RiveraTELEPHONE: (323) 629-7782
LICENSING EVALUATOR SIGNATURE:

DATE: 08/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2021
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: VASQUEZ FAMILY CHILD CARE
FACILITY NUMBER: 198004766
VISIT DATE: 08/18/2021
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
At 3:10 PM LPA observed cleaning compounds items stored inside the cabinets below the kitchen sink with a child proof lock in place making it inaccessible to children. Licensee understands that any poisons or firearms must be locked with a key or combination lock. For drinking water, LPA observed water jugs and individual cups.

LPA Rivera asked if there are any pets, poisons, firearms, weapons or bodies of water. Licensee stated she has a pet (dog) no firearms, or weapons. LPA did not observe firearms or weapons. Licensee was advised that if any poisons (ex; drano, rat poison or items with skull hazard symbol), firearms and weapons are purchased, it is required to be locked with a key or combination lock and firearm and ammunition must be stored separately.



At 3:15 PM LPA Rivera observed the required 2A10BC fire extinguisher located in the daycare room and the valve on the green area indicating fully charged and serviced on 2/4/21. LPA also observed the smoke/carbon monoxide alarm located in the hallway. At 3:19 PM LPA asked licensee son to press on the smoke detector/carbon monoxide combo alarm. LPA heard the sound which indicated the alarm is operating.

At 3:22 PM LPA inspected the outdoor area used by children in care for safety, comfort and cleanliness, LPA observed backyard to be fenced all around. LPA did not observed the backyard to be cleaned. LPA observed dog feces, carpenter materials such as wood, hammer, and a wood cutter machine. LPA observed the metal side gate open and the other metal gate placed against the wall. The side area behind the back house, LPA observed the side gate open, some debris and bicycles stored. Licensee stated her son is currently working on the side gate and replacing them with a wood gate. Licensee stated her son is currently working on the other side gate, and on the weekend Licensee hosted an event. LPA did not observe any children playing outdoors.

LPA observed licensee pediatric First Aid/CPR certification (expires July 15, 2022) and has proof of immunization against pertussis, and influenza dated 9/29/2020. Licensee missing measles immunization. Licensee has not completed the child abuse mandated reporter (AB 1207) training. Licensee was advised that the mandated reporter training must be completed every 2 years, and is available at www.mandatedreporterca.com.

At 3:35 PM LPA observed on the bulletin wall the children's facility roaster, LIC 610 Emergency Disaster plan, Parents Rights, License, facility sketch and earthquake/fire drill log and last drill conducted on 7/16/2021.

SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 981-3368
LICENSING EVALUATOR NAME: Mayra RiveraTELEPHONE: (323) 629-7782
LICENSING EVALUATOR SIGNATURE:

DATE: 08/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2021
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: VASQUEZ FAMILY CHILD CARE
FACILITY NUMBER: 198004766
VISIT DATE: 08/18/2021
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
The following was discussed
INFANT CARE: LPA Rivera reviewed and discussed Safe Sleeping Practices information with licensee and a plan for supervising sleeping infants. LPA advised the licensee to sleep infants in an area where infants can be directly supervised. Place infants on their backs to sleep, on a firm mattress with fitted sheet that fits snugly in crib or play yard. LPA also advised against sleeping infants in a separate room with no direct supervision and no pillows, crib bumpers, swaddling, head covered, and pacifiers must not have anything attached. Safe sleep brochure was provided.

LPA Rivera also reviewed Sudden Infant Death Syndrome (SIDS), Never Shake A Baby, and Lead Exposure information with licensee. LPAs also explained to licensee that car seat, stroller are only and only for transportation, highchair is only and only for feeding and stated items cannot be misused. No smoking, No infant walkers, No Johnny jumpers, No saucer chairs, No trampolines and any other item that falls into this category are not permitted in a family child care facility.



Medication: 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 Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

LPAs advised the licensee how to access forms, regulations and quarterly updates, and Providers Information Notices (PIN) online at: www.ccld.ca.gov



Licensee Zenaida is missing MMR (measles) immunization, has not completed the child abuse mandated reporter (AB 1207) training, A technical violation has been given for missing MMR. and child abuse mandated reporter (AB 1207) certification. Plan of correction is to submit proof by September 1, 2021.
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 981-3368
LICENSING EVALUATOR NAME: Mayra RiveraTELEPHONE: (323) 629-7782
LICENSING EVALUATOR SIGNATURE:

DATE: 08/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2021
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: VASQUEZ FAMILY CHILD CARE
FACILITY NUMBER: 198004766
VISIT DATE: 08/18/2021
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Children's files were reviewed during the inspection and LPA issued the Children's Record Review (LIC 857) to licensee. LPA did not observe immunization record for Child #1 in the file. Licensee called parent and parent sent via text the immunization record for child #1.

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



During the inspection spouse and son cleaned the backyard removed dog feces, wood and stored the wood, hammer and wood cutter machine away.

Licensee has been given a technical violation listed on the following pages. Exit interview was conducted and plans of correction were reviewed and developed with Licensee Zenaida Vasquez with due date September 1, 2021. Appeal rights explained & provided. A copy of this report and appeal rights were discussed and left with licensee, Zenaida Vasquez whose signature on this form confirms receipt of these documents.
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 981-3368
LICENSING EVALUATOR NAME: Mayra RiveraTELEPHONE: (323) 629-7782
LICENSING EVALUATOR SIGNATURE:

DATE: 08/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2021
LIC809 (FAS) - (06/04)
Page: 4 of 4