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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198018216
Report Date: 08/23/2022
Date Signed: 08/23/2022 05:24:20 PM


Document Has Been Signed on 08/23/2022 05:24 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:VAZQUEZ FAMILY CHILD CAREFACILITY NUMBER:
198018216
ADMINISTRATOR:VAZQUEZ, VICTORIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(213) 748-2858
CITY:LOS ANGELESSTATE: CAZIP CODE:
90011
CAPACITY:14CENSUS: 7DATE:
08/23/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Victoria Vasquez, LicenseeTIME COMPLETED:
05:35 PM
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On Tuesday, August 23 2022 at 2:30 p.m., Licensing Program Analyst (LPA) Mayra Rivera conducted an unannounced annual inspection and met with Licensee Victoria Vazquez who guided LPA Rivera on a tour of the facility.

During the inspection, 7 school age children were present eating p.m. snack. Family members residing in the home has been discussed with licensee and have obtained a criminal record clearance. Operating hours are Monday to Friday, 7:00 a.m. to 6:00 p.m., and care for children ages 0 to 18 years.

This facility is a two-story home that consists of three bedrooms, two bathrooms, kitchen, living room, front yard and backyard (fenced and gated). Areas that are accessible to children and identified on the facility sketch were inspected by LPA Rivera; living room, bathroom (first floor), kitchen and front yard Areas off limits to children include- bedroom, #1, # 2 second floor and backyard.

At approximately 2:35 p.m., LPA Rivera inspected the facility for safety, comfort, cleanliness, ventilation and working phone (cell phone and land line). For ventilation, LPA Rivera observed central AC/heater and vents located on the top ceiling walls and the thermostat to be set at 73 degrees. LPA observed the furniture and children materials to be in good condition and age appropriate. LPA observed a safety gate barrier installed below the staircase and with a lock to prevent children going up stairs.

At approximately 2:46 p.m., LPA Rivera entered the restroom and observed toilet, hand washing sink, hand soap and paper towels. LPA did not observe any hazards and observed the restroom to be in good condition.

At approximately 2:57 p.m., LPA observed cleaning compounds items stored inside the bottom kitchen sink cabinet. LPA observed child proof lock in place making it inaccessible for children to open the bottom sink cabinet. LPA observed knives stored inside cabinet above the stove making it inaccessible for children to reach. For drinking water, licensee provides water bottles and LPA observed a water dispenser.

SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 981-3368
LICENSING EVALUATOR NAME: Mayra RiveraTELEPHONE: (323) 629-7782
LICENSING EVALUATOR SIGNATURE:
DATE: 08/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/23/2022
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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: VAZQUEZ FAMILY CHILD CARE
FACILITY NUMBER: 198018216
VISIT DATE: 08/23/2022
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At approximately 3:05 p.m.,, LPA Rivera inspected the outdoor front area used by children for safety, comfort and cleanliness. LPA observed play equipment to be in good condition and age appropriate. LPA observed the front yard gated and fenced. LPA observed the gate to be closed with a self-latch and lock. LPA observed the side gates to be closed and locked.

LPA Rivera asked if there’s any pets, firearms, weapons or bodies of water. Licensee stated she has three dogs (German Shepherd, huskie and maltese poodle), a pool and no firearms, nor weapons. LPA observed two dogs German Shepherd, and huskie and also observed an above ground pool. LPA observed the pool gate door self- latch and swing away from the pool and measured the fence. The fence is 5ft in height and spacing in between to be 3.5 inches. 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 approximately 3:13 p,m., LPA Rivera observed the correct 2A10BC fire extinguisher located in the kitchen with the valve on the green area indicating fully charged and purchase receipt 6/25/22. Licensee tested the combo smoke detector /carbon monoxide located in the living room and kitchen. LPA heard the detectors and are in operable condition. LPA observed emergency kit/first aid kit in the laundry room and the kits are fully equipped with bandages, adhesives, gauzes, roller bandages. LPA observed the fire/earthquake drill log and last drill conducted on 8/14/22.

LPA observed licensee Victoria Vazquez Pediatric First Aid/ CPR certification with expiration date 10/2023, Health and Safety Certificate dated 8/12/2007, AB 1207 Child Abuse Mandated Certificate dated 3/9/22 and immunization against Pertussis, MMR and Influenza.. Licensee was advised that the mandated reporter training must be completed every 2 years, and is available at www.mandatedreporterca.com

At approximately 3:53 p.m LPA reviewed the roster, licensee file, staff #1 and child #1 files. LPA observed the files to be completed.

LPA observed LIC 610A Emergency Disaster Plan, Pub 394 Notification of Parents Rights, LIC 999 Facility sketch posted on a bulletin board located in the living room.

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

DATE: 08/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2022
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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: VAZQUEZ FAMILY CHILD CARE
FACILITY NUMBER: 198018216
VISIT DATE: 08/23/2022
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Safe Sleep: LPA discussed the safe sleep regulations with licensee Victoria Vazquez 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 licensee Victoria Vazquez of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at also explained to licensee that car seat, stroller are only and only for 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 Rivera also reviewed Sudden Infant Death Syndrome (SIDS), Never Shake A Baby, and Lead Exposure information with licensee. Car seats are 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

Criminal Record Statement: Licensee Victoria Vazquez was reminded that all adults 18 and over living or working in the home, 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.

Licensee has been given technical violations for missing LIC 9221 Safe Sleep Plan and Sleep Log.

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

Exit interview conducted and report was reviewed along with appeal rights with the licensee Victoria Vazquez

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

DATE: 08/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2022
LIC809 (FAS) - (06/04)
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