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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543910596
Report Date: 10/18/2019
Date Signed: 10/18/2019 12:09:12 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, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:VASQUEZ, ZULEMA FAMILY CHILD CAREFACILITY NUMBER:
543910596
ADMINISTRATOR:VASQUEZ, ZULEMAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 329-1724
CITY:VISALIASTATE: CAZIP CODE:
93277
CAPACITY:14CENSUS: 3DATE:
10/18/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Zulema VasquezTIME COMPLETED:
12:15 PM
NARRATIVE
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On this date, Licensing Program Analyst (LPA), Theresa Marquez, conducted an unannounced annual inspection and was met by Licensee, Zulema Vasquez. Also present was Licensee’s Assistant/mother Maria Diaz Chinchilla. LPA toured the home inside and outside and a census was taken. Licensee has a working telephone and the above telephone number was verified.

Postings such as Emergency Disaster Plan, Earthquake preparedness checklist, facility license and Notification of Parents Rights poster are posted on the living room #2 wall.

Current facility sketch reviewed, and Licensee confirmed that living room #2, the kitchen/dining area and hall bathroom are used for providing care and are accessible to children. All other rooms are off-limits and made inaccessible by use of children’s safety gates and door knob spinners. Safe toys and play equipment are observed. There are no stairs in this home. The fireplace located in the living room #2 is made inaccessible and will not be in use during day-care hours. There is working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort.

Cleaning compounds, medication and other hazardous items are made inaccessible. There are no firearms or ammunition on the premises. No poisons were observed during inspection.

The outdoor play area in the backyard is fenced and there are no hazards to children present. There are no swimming pools or other bodies of water on the premises. No pets were observed.

Capacity as specified on the license is being maintained. Licensee’s pediatric CPR/First Aid expires on 1/13/2020. An emergency fire/disaster drill has been completed within the last 6 months.

Hours of operation are Monday - Saturday, 24 hours per day as arranged. Licensee understands she can not care for any children for 24 or more consecutive hours at a time.

Continued LIC809-C

SUPERVISOR'S NAME: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Theresa MarquezTELEPHONE: (559) 341-7123
LICENSING EVALUATOR SIGNATURE:

DATE: 10/18/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2019
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, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: VASQUEZ, ZULEMA FAMILY CHILD CARE
FACILITY NUMBER: 543910596
VISIT DATE: 10/18/2019
NARRATIVE
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A review of records indicates that immunization records are in file for children and adults. Licensee has a current roster of the children and maintains emergency information and forms as required. Adequate supervision is being provided during this visit. All adults who reside or work in the home have a criminal record clearance.

Incidental Medical Services (IMS) are not currently being provided. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide these services.



The following information regarding Americans with Disability Act (ADA) was provided: US Department of Justice toll free ADA Information line at (800) 514-0301 (voice) and (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm for Commonly Asked Questions about Child Care Centers and the ADA.

LPA and Licensee discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINS), Quarterly Updates, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiency is found (see next page): LIC809-D

A copy of Licensee Appeal Rights was provided to Zulema Vasquez today.

This report shall be made available to the public upon request.

LIC 9213 Notice of Site Inspection is provided and required to be posted for 30 days.

SUPERVISOR'S NAME: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Theresa MarquezTELEPHONE: (559) 341-7123
LICENSING EVALUATOR SIGNATURE:

DATE: 10/18/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2019
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, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: VASQUEZ, ZULEMA FAMILY CHILD CARE
FACILITY NUMBER: 543910596
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/18/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/01/2019
Section Cited

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TRAINING FOR MANDATED REPORTER - On or before 3/30/2018, a person who, on 1/1/2018, is a licensed child care provider, admin., 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 2 years following the date on which he or she completed the initial mandated reporter training.
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This requirement was not met as evidenced by interview and record review. Licensee could not provide evidence of completing the required Mand. Reporter Training. This poses a potential Health, Safety, Personal Rights risk to children in care.
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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: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Theresa MarquezTELEPHONE: (559) 341-7123
LICENSING EVALUATOR SIGNATURE:
DATE: 10/18/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/18/2019
LIC809 (FAS) - (06/04)
Page: 3 of 3