426215708-10-12-2022-17-CC-GRES-CK5VAR-20221012161622

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 426215708
Report Date: 10/12/2022
Date Signed: 10/12/2022 04:16:43 PM

Document Has Been Signed on 10/12/2022 04:16 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:	VAZQUEZ FCC AKA LOVE DROP CHILD CARE		FACILITY NUMBER:	426215708
ADMINISTRATOR:	ITXEL VAZQUEZ-ALVARADO		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 478-4106
CITY:	SANTA MARIA	STATE: CA	ZIP CODE:	93454
CAPACITY:	14	CENSUS: 11	DATE:	10/12/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Itxel Vazquez Alvarado		TIME COMPLETED:	04:10 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 10/12/2022 at 1:00 PM , Licensing Program Analyst Gigi Reyes conducted an unannounced 1 Year Required inspection and met with Licensee, Itxel Vazquez. 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. There were five (5) children and 2 staff present, when LPA arrived. On or about 2:45 PM, six (6) additional school age children were picked up by the licensee. During the facility personnel review, LPA observed that the assistant, Dulce Garduno is not associated with the Vazquez Family Child Care Home. Licensee stated that her assistant started working in 6/20/2022, and that she was previously employed with another FCCH. LPA in the company of Licensee toured the home inside and outside. This is a 3 bedroom home and 3 baths. Living room, family room, kitchen, bathroom, backyard are accessible to day care children. The 3 bedroom and garage are off limits. LPA observed age appropriate toys and equipment, LPA observed smoke and carbon monoxide detectors in the home. The regulation fire extinguisher was serviced on 8/1/2022. Home conducts and documents fire and disaster drill every 6 months, last drill was conducted on 4/20/2022. The backyard is enclosed by a brick wall. LPA observed age appropriate toys and play equipment in the back yard. No bodies of water were observed on site. Licensee stated there are no guns or ammunition in the home. Continued on LIC 809C

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi Reyes	TELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:	DATE: 10/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2022

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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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: VAZQUEZ FCC AKA LOVE DROP CHILD CARE	FACILITY NUMBER: 426215708
	VISIT DATE: 10/12/2022

NARRATIVE

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LPA Reyes reviewed facility file, Pediatric CPR and First Aid expires on 6/5/2024 Licensee and Assistant renewed the Mandated Reporter Training Certificates which expire on 6/13/2024. Children's files were reviewed.

Licensee checks and documents napping Infant, however Infant # 1 does not have LIC 9227 , Infant Safe Sleep Plan on file. Child # 1, Child # 3 and Child # 4's immunization are not documented on CDPH 286/PM 286

During today's inspection, Type A and Type B deficiencies were cited under Title 22 Division 12. and Health and Safety Code. CIvil nelaty of $500.0 was assessed.

LPA Reyes informed licensee Ms. Vazquez that this report dated 10/12/2022 documents one (1) Type A citation which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care.Also, LPA Reyes informed the licensee, Ms. Vazquez to provide a copy of this licensing report dated 10/12/2022 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Home 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.

Continued on LIC 809 C

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi Reyes	TELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:	DATE: 10/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2022

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, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: VAZQUEZ FCC AKA LOVE DROP CHILD CARE	FACILITY NUMBER: 426215708
	VISIT DATE: 10/12/2022

NARRATIVE

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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. Itxel Vazquez

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi Reyes	TELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:	DATE: 10/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 10/12/2022 04:16 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, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: VAZQUEZ FCC AKA LOVE DROP CHILD CARE	FACILITY NUMBER: 426215708
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/12/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

102370(d)(2)

Criminal Record Clearance

(d) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: (2) Request a transfer of a criminal record clearance as specified in Section 102370(j) or This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on facility personnel review, the licensee did not comply with the section cited above, Assistant, Dulce Garduno's criminal record clearance was not associated with Vazquez FCCH which poses an immediate health, safety or personal rights risk to persons in care. A civil penaly of $500.00 was assessed.
	POC Due Date: 10/13/2022
	Plan of Correction
1 2 3 4	Licensee agreed to submit a written plan of correction to Community Care Licensing on or before 10/13/2022 on how to ensure that all individual prior to working or living in the home shall have a a criminal record clearance associated with the facility.

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: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi Reyes	TELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:	DATE: 10/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 10/12/2022 04:16 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, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: VAZQUEZ FCC AKA LOVE DROP CHILD CARE	FACILITY NUMBER: 426215708
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/12/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102425(c)

Infant Safe Sleep

An Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be completed for each infant up to 12 months of age the provider has in care and included in the infant's file at the facility. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above Infant # 1 does not have Individual Safe Sleep Plan (LIC 9227) on file which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 10/24/2022
	Plan of Correction
1 2 3 4	Licensee agreed to discuss the Individual Safe Sleep Plan with parent of Infant # 1 and to ensure that it completed. Writtedn plan of correction will be submitted to CCL no later than 10/24/2022.

Type B

Section Cited

CCR

102418(g)

(g) The licensee shall document each child's immunizations as required by the California Code of Regulations, Title 17, Section 6070, and shall maintain such documentation for as long as the child is enrolled. (1) This requirement includes updating each child's PM 286 (6/95) when the child is due to receive required immunizations after enrollment in the family day care home. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in 3 out of 5 day care children, C1, C3, C4's immunization is no documented and updated in the child's PM 286 which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 10/24/2022
	Plan of Correction
1 2 3 4	Licensee agreed to submit a plan of correction to CCL no later thatn 10/24/2022 on how to ensure that children's immunization record are updated in the child's PM 286.

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	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi Reyes	TELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:	DATE: 10/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2022

LIC809 (FAS) - (06/04)

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