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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334841642
Report Date: 07/08/2021
Date Signed: 07/08/2021 04:28:04 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:VASQUEZ FAMILY CHILD CAREFACILITY NUMBER:
334841642
ADMINISTRATOR:VASQUEZ, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 541-3251
CITY:INDIOSTATE: CAZIP CODE:
92203
CAPACITY:14CENSUS: 15DATE:
07/08/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Maria VasquezTIME COMPLETED:
05:00 PM
NARRATIVE
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On July 08, 2021, at 12:30 p.m., Licensing Program Analyst's (LPAs) Blanca Ruiz-Silva and Laura Mejorado arrived at facility to conduct an inspection to initiate a complaint investigation 09-CC-20210707143630. Upon arrival to the facility LPAs observe 15 children in care at the facility which is in excess of the licensed capacity.

The above actions constitutes a violation for failure to adhere to regulation 102416.5(a) Staffing Ratio and Capacity for failing to remain in substantial compliance.

During today's visit, LPAs spoke with licensee regarding a plan of corrections associated with the deficiency stated above and deficiency was cleared during inspection.

Please see Lic 809D for deficiency cited.

An exit interview was conducted with licensees, Maria Vasquez. Appeals rights were discussed Licensees understand that a copy of this report must be made available to the public, upon their request, for the next three years.
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Blanca Ruiz-SilvaTELEPHONE: (951) 233-5594
LICENSING EVALUATOR SIGNATURE:

DATE: 07/08/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2021
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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: VASQUEZ FAMILY CHILD CARE
FACILITY NUMBER: 334841642
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/08/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/08/2021
Section Cited

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The capacity specified on the license shall be the maximum number of children for whom care may be provided at any one time. This requirement was not met as evidenced by:
Upon arrival to the facility, LPA's observed 15 children in care which is in excess of the licensed capacity. "This is a potential risk to the health and safety of children in care".

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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: Aaron RossTELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Blanca Ruiz-SilvaTELEPHONE: (951) 233-5594
LICENSING EVALUATOR SIGNATURE:
DATE: 07/08/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/08/2021
LIC809 (FAS) - (06/04)
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