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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426209722
Report Date: 07/19/2022
Date Signed: 07/19/2022 03:41:47 PM

Document Has Been Signed on 07/19/2022 03:41 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, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:VASQUEZ FCC AKA BUMBLEBEE DAYCAREFACILITY NUMBER:
426209722
ADMINISTRATOR:ANNYVETTE VASQUEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 925-0365
CITY:SANTA MARIASTATE: CAZIP CODE:
93454
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 4DATE:
07/19/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Annyvette VasquezTIME COMPLETED:
03:45 PM
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On 7/19/ 2022 at 12:45 PM, Licensing Program Analyst (LPA) Gigi Reyes conducted an unannounced 1 Year Required inspection and met with Licensee, Ms. Vasquez LPA asked pre screening questions related to COVID- 19 and licensee’s responses indicate there are no COVID -19 exposures on site. LPA discussed the purpose of the inspection with the Licensee. There were 4 napping children when LPA arrived.

LPA and Licensee toured the interior and exterior of the day care. This is a two story home with 3 bedrooms and 2 baths. FCCH uses the living room, dining area, kitchen, 1 bathroom and backyard LPA observed smoke and carbon monoxide detectors in the home. The regulation fire extinguisher was purchased on 1/5/2022. Home conducts and documents fire and disaster drill every 6 months, last drill was conducted on 6/3/2022. The backyard is enclosed by wooden fence. LPA observed age appropriate toys and play equipment. LPA also observed a spa which is covered and secured with a chain lock. Licensee stated it is no longer in use. Licensee stated guns and ammunition are stored separately in a locked safe.

LPA Reyes reviewed facility file, Pediatric CPR and First Aid expires on 1/8/2024. Licensee has proof of immunization and tuberculosis clearance on file, FCCH has current roster of children in care. Licensee did not take/renew the Mandated Reporter Training per AB 1207. The children's records were reviewed and found complete. Licensee cares for infant but not present at the time of the inspection.

During today's inspection, deficiency was cited and Technical Assistance was provided and issued.

Continued on 809-C
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE: DATE: 07/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/19/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: VASQUEZ FCC AKA BUMBLEBEE DAYCARE
FACILITY NUMBER: 426209722
VISIT DATE: 07/19/2022
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This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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
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.

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
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.

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

Exit interview conducted and report was reviewed with the licensee, Ms. Annyvette Vasquez.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2022
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Document Has Been Signed on 07/19/2022 03:41 PM - It Cannot Be Edited


Created By: Gigi Reyes On 07/19/2022 at 03:17 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: VASQUEZ FCC AKA BUMBLEBEE DAYCARE
FACILITY NUMBER: 426209722

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/19/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
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
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Based on record review, the licensee did not comply with the section cited above, licensee did not take the Mandated Reorter Training per AB 1207 which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/29/2022
Plan of Correction
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Licensee agreed to teake the Mandated Reporter training and submit the certificate to CCL no later than 7/29/2022.

gigi.reyes@dss.ca.gov
francisca.velazquez@dss.ca.gov
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Maria Mueller
LICENSING EVALUATOR NAME:Gigi Reyes
LICENSING EVALUATOR SIGNATURE:
DATE: 07/19/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/19/2022


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