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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 115408454
Report Date: 05/21/2024
Date Signed: 05/21/2024 03:53:55 PM

Document Has Been Signed on 05/21/2024 03:53 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, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME:VAZQUEZ, OFELIA FAMILY CHILD CARE HOMEFACILITY NUMBER:
115408454
ADMINISTRATOR/
DIRECTOR:		VAZQUEZ, OFELIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 884-9454
CITY:WILLOWSSTATE: CAZIP CODE:
95988
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
05/21/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:38 PM
MET WITH:Ofelia VazquezTIME VISIT/
INSPECTION COMPLETED:
04:00 PM
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A prelicensing inspection was conducted on 5/21/24 at 2:38pm by Licensing Program Analyst (LPA) Bianca Mendez. This is in response to a change of location application that was received by CCL. The applicant is requesting a license for a capacity of 14. Services will be provided Monday through Friday; 5:00am - 5:00pm. The applicant understands that child care must be provided in the "primary" residence of the applicant. The residence is a three bedroom/ one bath home. There are two adults living in the home. Applicant was advised that all adults residing or working at the facility must have a criminal background clearance on file with CCLD. All minors residing in the home must be fingerprinted within 30 days of reaching their 18th birthday and obtain a TB clearance. The applicant is aware of the immediate $100 per day civil penalty for adults working or residing in the home without a criminal record clearance. A fire clearance was granted for 5/15/24.

The off limit areas of 2 bedrooms, laundry room, basement ,garage and are made inaccessible by lock and gate. The home appears to be clean and orderly at this time and will remain so during child care hours. There is a working telephone present. Poisons were observed and poisons were locked and made inaccessible in garage. The children in care will have access to age appropriate toys and equipment. The home is equipped with a working smoke detector, carbon monoxide detector and fire extinguisher rated at least 2A10BC. The children will use the back yard as the outdoor play area is fully fenced. There is a above ground pool located on the premises and currently does not meet Title 22 regulations.
SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Bianca Mendez
LICENSING EVALUATOR SIGNATURE: DATE: 05/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/21/2024
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, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME: VAZQUEZ, OFELIA FAMILY CHILD CARE HOME
FACILITY NUMBER: 115408454
VISIT DATE: 05/21/2024
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The licensee was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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.

LPA discussed the safe sleep regulations with Licensee Ofelia Vazquez and discussed the Child Care Licensing Safe Sleep web page 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.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.
To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at: https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

The following items need to be completed prior to the granting of license:
1. Pool must meet Title 22 Regulations.

Report was reviewed with Licensee Ofelia Vazquez and Appeal rights were provided.
SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Bianca Mendez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2024
LIC809 (FAS) - (06/04)
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