334841642-12-1-2022-10-CC-LVAA-CLQ3J7-20221201171704

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 334841642
Report Date: 12/01/2022
Date Signed: 12/01/2022 05:17:33 PM

Document Has Been Signed on 12/01/2022 05:17 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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME:	VASQUEZ FAMILY CHILD CARE		FACILITY NUMBER:	334841642
ADMINISTRATOR:	VASQUEZ, MARIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(760) 541-3251
CITY:	INDIO	STATE: CA	ZIP CODE:	92203
CAPACITY:	14	CENSUS: 8	DATE:	12/01/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:45 PM
MET WITH:	Maria Vasquez		TIME COMPLETED:	05:30 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	On 12/01/2022, Licensing Program Analyst (LPA) Lorena Valenzuela arrived at the facility to conduct an annual inspection as part of a compliance review. LPA toured the facility, inside and out, records were reviewed, and the following was observed and/or discussed: · Normal days and hours of operation are: Monday through Sunday 5:00am-12:00pm · Off-limit areas include: bedroom 2, 3, and backyard and laundry room · The facility is licensed to have no more than 14 children as a large family child care home and is operating within the licensed capacity and appropriate ratios. · Appropriate supervision provided during this inspection · A working telephone is present, and the current phone number is on file · A fully charged fire extinguisher was observed. A smoke detector and carbon monoxide detector were present and tested by the Licensee during this inspection. · There is no fireplace in the home · All hazardous items are stored inaccessible to children · Toxins are locked · Weapons are not present/stored according to Title 22. Licensee understands all guns, weapons and ammunition must be key locked separately and made inaccessible per Title 22 Regulations · This is a one story home · Clean, safe and age appropriate toys · Current roster not on file · Facility Sketch, Emergency Disaster Plan and Notification of Parent’s Rights poster are posted · Documentation of fire and disaster drills are not on file – per the licensee she last drill conducted about 3 months ago, licensee understands drills must be conducted every 6 months and be documented

SUPERVISOR'S NAME: Stephanie Hudak	TELEPHONE: (951) 320-2101
LICENSING EVALUATOR NAME: Lorena Valenzuela	TELEPHONE: (951) 233-9356
LICENSING EVALUATOR SIGNATURE:	DATE: 12/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2022

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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Document Has Been Signed on 12/01/2022 05:17 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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: VASQUEZ FAMILY CHILD CARE	FACILITY NUMBER: 334841642
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 12/01/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102425(a)

Infant Safe Sleep

(a) There shall be one crib or play yard for each infant who is unable to climb out of the crib or play yard. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview, and observation, the licensee did not comply with the section cited above in licensee does not have a crib or play yard for infant to sleep in which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 12/02/2022
	Plan of Correction
1 2 3 4	Licensee agrees to purchase a crib or play yard for infant to sleep in by due date 12/02/2022 , and will submit picture of the product to the Department.

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 licensees did not complete mandated reporter training, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 12/30/2022
	Plan of Correction
1 2 3 4	Licensee agrees to submit proof of completed mandated reporter training ( for both licensees) to the Department by due date 12/30/2022.

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: Stephanie Hudak	TELEPHONE: (951) 320-2101
LICENSING EVALUATOR NAME: Lorena Valenzuela	TELEPHONE: (951) 233-9356
LICENSING EVALUATOR SIGNATURE:	DATE: 12/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 12/01/2022 05:17 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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: VASQUEZ FAMILY CHILD CARE	FACILITY NUMBER: 334841642
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 12/01/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1597.622(a)(1)

General Provisions and Definitions

(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. 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 licensees do not have record on file of measles and pertussis immunizations which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 12/30/2022
	Plan of Correction
1 2 3 4	Licensee agrees to submit proof of immunizations for measles and pertussis both licensees by due date 12/30/2022.

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: Stephanie Hudak	TELEPHONE: (951) 320-2101
LICENSING EVALUATOR NAME: Lorena Valenzuela	TELEPHONE: (951) 233-9356
LICENSING EVALUATOR SIGNATURE:	DATE: 12/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2022

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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: VASQUEZ FAMILY CHILD CARE	FACILITY NUMBER: 334841642
	VISIT DATE: 12/01/2022

NARRATIVE

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·No bodies of water at this time. Licensee understands all bodies of water including ponds, above ground pools & spas, in-ground pools & spas, and some fountains must be properly covered or fenced per Title 22 Regulations. The Department must be notified before and after installation of the above types of bodies of water. In addition, all wading pools or similar product must be emptied immediately after use and stored in an upright position.
· Verification of control of property on file
· Children’s records are not complete, two children are missing immunization records, one child is missing the LIC 9227 and sleep log. In addition, per interview and observation one child (infant) does not have a crib or play yard for sleep, per licensee the child/infant sleeps in a sleep cot.
· Employee’s records are complete due to Mandated Reporter Training not being completed by licensees. In addition, licensees do not have proof of measles and pertussis immunization records on file.
· Pediatric CPR and First Aid Card expire on 08/2024
· Health & Safety Certificate - completed on 06/23/2011
· Resident and/or staff records were reviewed and all adults who require caregiver background checks have received all required clearances and/or exemptions.

The licensee confirmed that there are no Registered Sex Offenders living in the facility and/or using the facility address for their mailing address.

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
The Licensee was informed of their reporting requirements and was provided with the Regional Office’s Unusual Incident Reporting email mailbox: UnusualIncidentReportsDO10@dss.ca.gov

The Licensee can submit transfer forms to associate new individuals or to disassociate someone from the facility at: Associations_Disassociations858@dss.ca.gov

SUPERVISOR'S NAME: Stephanie Hudak	TELEPHONE: (951) 320-2101
LICENSING EVALUATOR NAME: Lorena Valenzuela	TELEPHONE: (951) 233-9356
LICENSING EVALUATOR SIGNATURE:	DATE: 12/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2022

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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: VASQUEZ FAMILY CHILD CARE	FACILITY NUMBER: 334841642
	VISIT DATE: 12/01/2022

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-and-resources/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 also provided licensee with PIN 20-24 CCP, regarding sleep regulations in effect (in Spanish)
Licensee 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.
Go to the licensing webpage www.ccld.ca.gov, and click on the “Receive Important Updates” located on the right side of the page, immediately above the Quick Links. One can add their email address and choose which program(s) they wish to receive Provider Information Notices (PIN) for.

The Duty Officer is available to answer questions Monday – Friday; 8:00am to 5:00pm at:
1-844-LET-US-NO (1-844-538-8766) and/or 951-782-4200.

See deficiency pages for citations issued. Advisory Notes (LIC 9102TV) Technical Violations were also issued.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.
An exit interview was conducted, and this report was reviewed with the licensee Maria Vasquez. Appeal rights were discussed and provided during the exit interview.

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

SUPERVISOR'S NAME: Stephanie Hudak	TELEPHONE: (951) 320-2101
LICENSING EVALUATOR NAME: Lorena Valenzuela	TELEPHONE: (951) 233-9356
LICENSING EVALUATOR SIGNATURE:	DATE: 12/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2022

LIC809 (FAS) - (06/04)

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