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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364840931
Report Date: 07/23/2019
Date Signed: 07/23/2019 04:57:31 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550
FACILITY NAME:REYES-VASQUEZ FAMILY CHILD CARE HOMEFACILITY NUMBER:
364840931
ADMINISTRATOR:CECILIA REYESFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 577-2341
CITY:BARSTOWSTATE: CAZIP CODE:
92311
CAPACITY:14CENSUS: 3DATE:
07/23/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Cecilia ReyesTIME COMPLETED:
05:03 PM
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Licensing Program Analyst (LPA) Maddox met with licensee, Cecilia Reyes today for the purpose of conducting an unannounced Case Management inspection. Licensee has a permit from the City of Barstow/Building and Safety dated 1/18/19 for her single family home to be converted into 2 units (25645 #1&2 W. Main Street). Licensee is anticipating moving to the other side of her home, currently licensee is occupying Unit #1, Unit #2 was vacant during this inspection. Licensee is in the process of renovating Unit #2 for her to move into (pictures taken), and she is planning on renting out Unit #1 when renovations are complete.

This inspection is also conducted regarding an UIR received regarding child #1. From information received, #1 child falls a lot (beginning walking stages) and when she falls, she bites her tongue (due to birth defect). Licensee stated she has had conversations with mom who wants Licensee to provide 1:1 and always tells her to make sure her daughter does not fall but due to special needs, child falls often. Licensee stated she has asked parent to provide her with the diagnoses of child #1's "special needs" so she would be able to provide adequate care to child, licensee states she has never received any such documentation. Child #1 no longer attends this day care, last day was 5/1/19.

LPA also provided consultation to licensee who plans on converting the entire home into a Child Care Center in the future.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Donna MaddoxTELEPHONE: (661) 568-8971
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2019
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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