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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376614893
Report Date: 06/04/2019
Date Signed: 06/04/2019 01:12:51 PM

COMPREHENSIVE INSPECTION
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:VAZQUEZ, PATRICIA FAMILY CHILD CAREFACILITY NUMBER:
376614893
ADMINISTRATOR:PATRICIA VAZQUEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 584-2246
CITY:SAN DIEGOSTATE: CAZIP CODE:
92105
CAPACITY:14CENSUS: 5DATE:
06/04/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Patricia VazquezTIME COMPLETED:
01:15 PM
NARRATIVE
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LPA, Luigi Gargaro, conducted an unannounced inspection with the licensee. The home was toured and inspected to ensure an environment safe for the care and supervision of children per the standards established in CCR, Title 22, Division 12, Chapter 3, for Family Child Care Homes. Present were the licensee and five day care children. The fire extinguisher and smoke and carbon monoxide detectors meet requirements and are operational. All hazardous items were latched/locked and secured out of reach of children. There are no bodies of water or weapons in the home. A review of staff records on this date indicates that all adults or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions. First Aid and CPR certifications expire on April of 2020 for the licensee. Children’s records were reviewed.

Licensee has provided adequate space for the children to eat, sleep and play within the home. Areas used for child care include the main day care room off day care entry door and the day care bathroom. Off limits areas include the remainder of the home. The rest of the home is made inaccessible with an installed safety gate that is in front of the entranceway that leads to the front portion of the home. The licensee has sufficient toys and equipment available. The home has a fenced backyard play area available for outdoor activities.

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. LPA and licensee discussed California Megan's Law and he provided licensee with the website address: www.meganslaw.ca.gov for her to review information regarding her facility on a regular basis.
SUPERVISOR'S NAME: Jason GarayTELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Luigi GargaroTELEPHONE: (619) 767-2229
LICENSING EVALUATOR SIGNATURE:

DATE: 06/04/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: VAZQUEZ, PATRICIA FAMILY CHILD CARE
FACILITY NUMBER: 376614893
VISIT DATE: 06/04/2019
NARRATIVE
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Licensee was cited a type B deficiency today related to a reporting requirement violation for a substantiated child wandering incident that occurred on 05/24/19. Deficiency was cited on corresponding 809D page.
SUPERVISOR'S NAME: Jason GarayTELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Luigi GargaroTELEPHONE: (619) 767-2229
LICENSING EVALUATOR SIGNATURE:

DATE: 06/04/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2019
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: VAZQUEZ, PATRICIA FAMILY CHILD CARE
FACILITY NUMBER: 376614893
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/04/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/05/2019
Section Cited
CCR
102416.2(b)
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Reporting Requirements. The licensee shall report to the Department any of the events as specified in Health and Safety Code Section 1597.467(b)(1)(A)
through (b)(1)(C) that occur during the operation of the family child care home.
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Licensee understands that any future incidents that affect the health and safety of any child in care must be reported verbally to CCL within 24 hours and then in written form within 7 days. Licensee states she will submit a written unusual incident report to analyst by 06/05/19 to correct the deficiency.
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This requirement was not met as evidenced by fact that licensee failed to submit a written unusual incident report about a significant lack of supervision incident that occurred when a four and a half year old child walked out of the day care home and was found wandering by the San Diego Police Department. Licensee stated that she did report it verbally when leaving a message on the main office phone voicemail. Not reporting a significant incident of a child leaving and wandering from the facility is a risk to their health and safety.
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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: Jason GarayTELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Luigi GargaroTELEPHONE: (619) 767-2229
LICENSING EVALUATOR SIGNATURE:

DATE: 06/04/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2019
LIC809 (FAS) - (06/04)
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