393620475-11-9-2022-53-CC-BENN-CL7R3S-20221115114025

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 393620475
Report Date: 11/09/2022
Date Signed: 11/09/2022 11:15:06 AM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/13/2022 and conducted by Evaluator Salene Mayberry

COMPLAINT CONTROL NUMBER: 53-CC-20220913110403

FACILITY NAME:	VAZQUEZ, VELIA		FACILITY NUMBER:	393620475
ADMINISTRATOR:	VAZQUEZ, VELIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(209) 914-3805
CITY:	TRACY	STATE: CA	ZIP CODE:	95377
CAPACITY:	14	CENSUS: 6	DATE:	11/09/2022
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Velia Vazquez		TIME COMPLETED:	11:30 AM

ALLEGATION(S):

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1. Day care home did not meet day care child's diapering needs.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Salene Mayberry met with Licensee, Velia Vazquez to deliver findings for the above complaint allegation.

It was alleged that the “Day care home did not meet day care child's diapering needs”. During the investigation LPA toured the facility, observed staff interactions with children in care, conducted interviews with parents and staff and obtained pertinent documents. Licensing received separate complaints for this facility and statements made by Reporting Parties consistently cited multiple instances of picking up children with soiled diapers and diapers appearing not to have been changed throughout the day. Interviews conducted by LPA also revealed issues relating to diapering.

Report Continued on LIC9099-C

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Salene Mayberry	TELEPHONE: 916-263-5744
LICENSING EVALUATOR SIGNATURE:	DATE: 11/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 1 of 3

Control Number 53-CC-20220913110403

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME: VAZQUEZ, VELIA	FACILITY NUMBER: 393620475
	VISIT DATE: 11/09/2022

NARRATIVE

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Based on a preponderance of evidence obtained the complaint regarding the above allegation was SUBSTANTIATED.

A Type B Deficiency was cited on the subsequent page (LIC9099-D) of this report.

An Exit interview was conducted in which the report was reviewed and discussed with Licensee. LPA provided a copy of the report and Appeal Rights to Licensee. A Notice of Site visit was posted by LPA and Licensee understands it must remain posted for 30 days.

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Salene Mayberry	TELEPHONE: 916-263-5744
LICENSING EVALUATOR SIGNATURE:	DATE: 11/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2022

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 53-CC-20220913110403

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME: VAZQUEZ, VELIA	FACILITY NUMBER: 393620475
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 11/09/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 11/23/2022 Section Cited CCR 102423(a)(2)	1 2 3 4 5 6 7	(a) Each child receiving services... shall have certain rights that shall not be…abridged...These rights include...the following:…(2) To receive safe, healthful, and comfortable accommodations... This requirement was not met as evidence by:	1 2 3 4 5 6 7	Licensee and her assistant will check diapers every two hours and will check the diaper of each child before they are allowed to go home for the day. In addition, Licensee will create a dailiy log for the children that will track diapering and food and will be provided to familes each week.
	8 9 10 11 12 13 14	Licensing received separate complaints citing multiple instances of picking up children with soiled diapers/diapers appearing not to have been changed throughout the day. Interviews also revealed issues relating to diapering. This poses a potential risk to the health and safety of children.	8 9 10 11 12 13 14	Licensee will provide LPA with a copy of this form once it is created.
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Salene Mayberry	TELEPHONE: 916-263-5744
LICENSING EVALUATOR SIGNATURE:	DATE: 11/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2022

LIC9099 (FAS) - (06/04)

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