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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543907943
Report Date: 09/04/2019
Date Signed: 09/10/2019 10:13:25 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:VAZQUEZ, OLGA & JORGE FAMILY CHILD CAREFACILITY NUMBER:
543907943
ADMINISTRATOR:VAZQUEZ, OLGA & JORGEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 667-5967
CITY:FARMERSVILLESTATE: CAZIP CODE:
93223
CAPACITY:14CENSUS: 4DATE:
09/04/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Olga VazquezTIME COMPLETED:
10:15 AM
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On this date, Licensing Program Analyst (LPA) Kathy Pacheco conducted an unannounced case management inspection. LPA met with Licensee, Olga Vazquez, to discuss an incident that occurred on 8/14/19. A complete file review was conducted prior to inspection. LPA took a census, interviewed staff, and observed area in which the incident occurred.

On 8/14/19, child 1 (see Confidential Names form (LIC 811) dated 9/4/19) and child 2 were in the living room area playing with staff member present. Child 1 was sitting down on his knees and child 2 was playing near child 1. Child 2 was playing Batman and threw himself down on the ground in front of child 1. Child 2 then threw his arm back and touched child 1's private parts. Staff saw this happen and immediately asked child 2 what was going on. Child 2 took his hand away from child 1, closed his eyes, and said "Don't talk to me, I'm dead". Staff then informed Licensee of the incident. Licensee spoke with child 2 and asked him what had happened. Child 2 told Licensee he touched child 1's private parts. Licensee asked child 2 why did he did that and he said, "I don't know". Licensee informed the parents of child 1 and child 2 of the incident at the time of pick up. Licensee said when child 2's parent arrived, they discussed the incident further. Licensee stated after speaking with the parents of child 2, they decided child 2 would no longer be attending the day care.

Based on the information obtained, LPA determined Licensee handled the incident correctly and reporting requirements were met. After interviewing staff, LPA determined Licensee took appropriate measures to address the incident by following proper policies and procedures. No regulations were violated.

Per California Code of Regulations Title 22, Division 12, no deficiency cited during today's inspection.

LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS.
SUPERVISOR'S NAME: Michael DuarteTELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Kathy PachecoTELEPHONE: (559) 341-5116
LICENSING EVALUATOR SIGNATURE:

DATE: 09/04/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2019
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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