198014728-7-7-2023-33-CC-RLOZ-CTJ39V-20230707180347

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198014728
Report Date: 07/07/2023
Date Signed: 07/07/2023 06:04:06 PM

Document Has Been Signed on 07/07/2023 06:04 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	VAZQUEZ FAMILY CHILD CARE		FACILITY NUMBER:	198014728
ADMINISTRATOR:	VAZQUEZ, SYLVIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(626) 409-0379
CITY:	EL MONTE	STATE: CA	ZIP CODE:	91732
CAPACITY:	14	CENSUS: 7	DATE:	07/07/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:15 PM
MET WITH:	Licensee, Sylvia Vasquez		TIME COMPLETED:	06:30 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	At 2:15 pm Licensing Program Analyst (LPA) Roxana Lopez conducted an unannounced required 1 year inspection to the above facility. A risk assessment was conducted upon entry- appropriate PPE was used. LPA met with Sylvia Vasquez, Licensee who guided analysts on a tour of the facility. Per Licensee, there are 11 children currently enrolled. A current children’s roster was available for review. There were 7 children present upon arrival- 2 being infants. Also present was Licensee’s assistant (husband) Upon arrival LPA observed child # 1 (infant) asleep in a stroller- baby was observed to be buckled in and stroller was fully covered with a blanket (covering infant’s head. Per licensee, infant does not stay asleep in playpen. LPA also observed child # 2 (infant) asleep in a playpen- playpen was observed to have additional mattress padding, blanket, pillow and bottle. This poses an immediate risk for children. During inspection, Licensee, removed child #1 from stroller and removed loose items from child # 2 playpen. The licensee states that 2 adults currently live in the home. Per Licensee, they currently have 1 assistant. All adults present in the home have obtained a criminal record clearance or exemption prior to working, residing or volunteering in the licensed child care home. Licensee states that there are no weapons stored in the home. This is a one story home which consists of 4 bedrooms, 2 bathrooms, living room, dining room, den, kitchen, garage front yard,and backyard (fenced). ----------------------------- pg. 1 of 5-----------------------

SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Roxana Lopez	TELEPHONE: (323) 854-5073
LICENSING EVALUATOR SIGNATURE:	DATE: 07/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2023

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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: VAZQUEZ FAMILY CHILD CARE	FACILITY NUMBER: 198014728
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/07/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

102425(i)

Infant Safe Sleep

If an infant falls asleep before being placed in a crib or play yard, the provider shall move the infant to a crib or play yard as soon as possible. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation the licensee did not comply with the section cited above in that LPA observed child # 1 asleep in a stroller. Infant was observed to be strapped in and stroller was cover completly cover with a blanket, which poses an immediate health, safety or personal rights risk to persons in care.
	POC Due Date: 07/14/2023
	Plan of Correction
1 2 3 4	During inspection, licensee removed child # 1 front stroller. Licensee and Assitant will watch personal rights video at ccld.childcarevideos.org and review sleep regulation102425- they will submit a decleration on what they've learned and plan moving forward to LPA by 4/16/2023

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Roxana Lopez	TELEPHONE: (323) 854-5073
LICENSING EVALUATOR SIGNATURE:	DATE: 07/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2023

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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: VAZQUEZ FAMILY CHILD CARE	FACILITY NUMBER: 198014728
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/07/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102425(b)

Infant Safe Sleep

(b) Cribs or play yards shall be free from all loose articles and objects. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above in LPA observed child # 2 sleeping in a playpen with a blanket, pillow and bottle, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/14/2023
	Plan of Correction
1 2 3 4	During inspection licensee removed all loose items from the crib. Licensee and Assitant will watch personal rights video at ccld.childcarevideos.org and review sleep regulation102425- they will submit a decleration on what they've learned and plan moving forward to LPA by 7/14/2023.

Type B

Section Cited

CCR

102425(j)(1)

Infant Safe Sleep

The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall physically check on the infant every 15 minutes. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview and (record review, the licensee did not comply with the section cited above in that there was no sleep log available for review for child # 1 and # 2, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/10/2023
	Plan of Correction
1 2 3 4	Per Licensee, they will begin documenting children's sleep and have documentation available for review starting on 7/10/2023.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Roxana Lopez	TELEPHONE: (323) 854-5073
LICENSING EVALUATOR SIGNATURE:	DATE: 07/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 07/07/2023 06:04 PM - It Cannot Be Edited

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: VAZQUEZ FAMILY CHILD CARE	FACILITY NUMBER: 198014728
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/07/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview and record review, the licensee did not comply with the section cited above in that both Licensee and assistant have not taken the required AB1207 mandated reporter training which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 08/04/2023
	Plan of Correction
1 2 3 4	Per Licensee, they will both take the training and submit copies of certificate to LPA by due date of 8/4/2023. Training can be taken on mandatedreporterca.com

Type B

Section Cited

CCR

102416(c)

Personnel Requirements

(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in that both Licensee and Assitant have expired cpr training which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 08/04/2023
	Plan of Correction
1 2 3 4	Per Licensee, they will take the required EMSA pediatric first aid and cpr and will submit copies of certificate to LPA by POC due date of 8/4/2023.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Roxana Lopez	TELEPHONE: (323) 854-5073
LICENSING EVALUATOR SIGNATURE:	DATE: 07/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 07/07/2023 06:04 PM - It Cannot Be Edited

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: VAZQUEZ FAMILY CHILD CARE	FACILITY NUMBER: 198014728
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/07/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102425(c)

Infant Safe Sleep

An Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be completed for each infant up to 12 months of age the provider has in care and included in the infant's file at the facility. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in that child # 1 and # 2 are missing LIC 9227 Individual Sleeping Plan on file which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/14/2023
	Plan of Correction
1 2 3 4	Per Licensee, they will provide form to parents- once completed they will place it on file for the department's review by POC due date of 7/14/2023

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Roxana Lopez	TELEPHONE: (323) 854-5073
LICENSING EVALUATOR SIGNATURE:	DATE: 07/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2023

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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: VAZQUEZ FAMILY CHILD CARE	FACILITY NUMBER: 198014728
	VISIT DATE: 07/07/2023

NARRATIVE

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The children have access to living room, dining room, den, kitchen (walkway), 2 bathrooms and back yard fenced.

Per licensee, areas off limits to children and parents include, 4 bedrooms, garage and front yard. The LPA toured all areas used by children during this visit.

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 landline and a cellphone. There is ventilation and heating (central). The following was observed and reviewed during this inspection.

Detergents, cleaning compounds, and medications were observed to be inaccessible to children. Per licensee, there are no poisons in the home. The bathroom that children use was observed to be safe and sanitary.

LPA Lopez did observed a fireplace in the living room which was barricaded and inaccessible for children in care. The valve on the required 2A 10BC fire extinguisher indicates fully charged and was serviced on 4/10/2023, as indicated on service tag. Smoke and carbon monoxide detectors were tested and are operable. All homes shall conduct fire and disaster drills at least once every six months, and document the date and time of each drill. Last drill documented was conducted on 4/2023.

Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted in the den.

The home is observed to be clean and orderly. There are toys available for children. Appropriate sleeping arrangements and playpen were observed.

-------------------------------------------------- pg. 2 of 5 -------------------------------------------------------------

SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Roxana Lopez	TELEPHONE: (323) 854-5073
LICENSING EVALUATOR SIGNATURE:	DATE: 07/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2023

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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: VAZQUEZ FAMILY CHILD CARE	FACILITY NUMBER: 198014728
	VISIT DATE: 07/07/2023

NARRATIVE

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LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA 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.

LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs, Trampolines and/or any other item that fall into these categories are not permitted in a family child care facility.

Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.

Currently, children are using the back yard for outdoor play time. The outdoor play area was observed to be fenced. LPA observed that the outdoor yard has toys and other materials for children to play with. LPA did not observe any objects that can pose a danger to children on the outdoor yard.

There are pets on the premises. LPA observed birds to be caged out in the backyard. 3 dogs were observed to be off limits.

The licensee is observed to be operating within the license capacity limitations.

At 3:30 pm children’s records were reviewed- LPA observed that Child # 1 and Child # 2 were missing the LIC 9227 Individual sleeping plan and sleep chart log.

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SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Roxana Lopez	TELEPHONE: (323) 854-5073
LICENSING EVALUATOR SIGNATURE:	DATE: 07/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2023

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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: VAZQUEZ FAMILY CHILD CARE	FACILITY NUMBER: 198014728
	VISIT DATE: 07/07/2023

NARRATIVE

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At 3:40 pm staff records were reviewed- LPA observed that Licensee and assistant did not have the required EMSA Pediatric Infant CPR- it expired on 6/30/2023. Additionally, both did not have proof of the Mandated Reporter AB 1207 compliant Child Care Training Certificate.

LPA observed that the Licensee and assistant do have proof of immunization record

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: https://www.ada.gov/resources/child-care-centers/.

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.

LPA advised the licensee to access forms, regulations and quarterly updates on line at: www.ccld.ca.gov.

Licensee, was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

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SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Roxana Lopez	TELEPHONE: (323) 854-5073
LICENSING EVALUATOR SIGNATURE:	DATE: 07/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2023

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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: VAZQUEZ FAMILY CHILD CARE	FACILITY NUMBER: 198014728
	VISIT DATE: 07/07/2023

NARRATIVE

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During the exit interview, the LICENSEE Sylvia Vasquez, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process

Based on the LPA’s observations and records review, the following deficiencies listed on the attached LIC 809D (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.

LPA Roxana Lopez informed licensee Sylvia Vasquez that this report dated 7/7/2023 document(s) 1 Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care. Also, LPA Roxana Lopez informed the licensee to provide a copy of this licensing report dated 7/7/2023 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

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

Exit interview conducted and report was reviewed with Licensee Sylvia Vasquez
----------------------------------------- pg. 5 of 5 -----------------------------------------------------------------------

SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Roxana Lopez	TELEPHONE: (323) 854-5073
LICENSING EVALUATOR SIGNATURE:	DATE: 07/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2023

LIC809 (FAS) - (06/04)

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