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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197413473
Report Date: 08/22/2023
Date Signed: 08/22/2023 02:14:14 PM

Document Has Been Signed on 08/22/2023 02:14 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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:VAZQUEZ FAMILY CHILD CAREFACILITY NUMBER:
197413473
ADMINISTRATOR:VAZQUEZ, PATRICIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 722-0946
CITY:LANCASTERSTATE: CAZIP CODE:
93536
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 4DATE:
08/22/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:47 AM
MET WITH:Patricia Vazquez,Licensee TIME COMPLETED:
02:30 PM
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On 08/22/23 Licensing Program Analyst (LPA) Justeene Tamayo met with Licensee, Particia Vazquez. This is a two story, 5 bedroom, 3 bathroom home with kitchen/dining, family room, living room, loft, laundry room and garage. There is no pool/spa or body of water on the premises. Upon arrival LPA observed 2 infants, 1 preschool children and 1 school age child in care, along with assistant #1. Family members residing in the home include 3 adults (licensee, licensee's husband, licensee's daughter) and three minor children. Incidental Medical Services (IMS) policy was discussed.

Physical Plant: Main care is provided in the living room and dining room area. Children use the bathroom in hallway on the left. Off limit areas include entire upstairs, kitchen,all bedrooms, bathrooms #2-3, laundry room, and garage. The home was inspected inside and out for safety, clean and orderly, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds (under kitchen sink with safety latch) and hazardous items (sharp knives in kitchen cabinet with safety latch) that can pose a danger to children. Medications are stored in lock box in master bedroom (off limits). LPA observed the fireplace to be screened in the main care area. Safe and age appropriate toys, play equipment and materials were observed. The smoke detector and carbon monoxide detector, Fire Extinguisher (2A10BC) are in operable condition. Per Licensee no one smokes in the home. Electrical outlets are inaccessible, no baby bouncers saucer chairs, or any recalled and or prohibited toys or sleep/ play equipment were observed on the premises. There is a designated area for ill children as necessary near the front entrance. Per Licensee there are no weapon/firearms in the home. The facility sketch is complete and current, there is working telephone (cell).

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE: DATE: 08/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/22/2023
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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: VAZQUEZ FAMILY CHILD CARE
FACILITY NUMBER: 197413473
VISIT DATE: 08/22/2023
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Fire/Disaster drill is complete and maintained current. Last fire/disaster drill was conducted on 05/12/2023

Roster complete and maintained current.

Bathroom: Shower/tub are free of hazards (child care bathroom). LPA observed the bathroom cabinet sink to have a safety latch. Toilet and faucet are clean and operable.

Kitchen: Sharp utensils, open bottles or alcohol are inaccessible. If food is brought from the children’s home, the container shall be labeled with the child’s name and properly stored or refrigerated. The home has a clean and fully stocked refrigerator/freezer. Cleaning supplies are under kitchen sink with safety latch. Breakfast, lunch, snacks and dinner are provided. Licensee currently does not have a food program. Children use cots for nap time in the living room.

Outdoor: The backyard is safe for children. The backyard is completely fenced (with block cement and two side gates). There is no body of water. LPA observed age appropriate toys in the backyard. Per licensee there is one bird on the premises. Licensee will either cover the outdoor air conditioner or barricade the outdoor air conditioner no later than 08/29/23.

Advisory/Other: First Aid kit was observed with supplies readily available. CPR/First Aid expires on 07/20/2024. Licensee cannot find her mandated reporter training. Licensee will retake her mandated reporter training at www.mandatedreporterca.com and send proof of completion to LPA Tamayo no later than 08/29/2023. There are no window cords accessible to children.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:

DATE: 08/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2023
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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: VAZQUEZ FAMILY CHILD CARE
FACILITY NUMBER: 197413473
VISIT DATE: 08/22/2023
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Documents Provided and or Discussed: Safe Sleep PIN 20-24-CCP, Safe sleep log, and the Individual Sleeping Plan (LIC 9227). LPA also discussed and provided licensee a copy of the Safe Sleep PIN 20-24-CCP. Licensee stated currently has child care insurance.

Licensee Vazquez 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.

LPA discussed the safe sleep regulations with licensee Vazquez 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.

No deficiencies have been cited at this time.

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

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the licensee Patricia Vazquez, along with her appeal rights and Notice of Site Visit.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:

DATE: 08/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2023
LIC809 (FAS) - (06/04)
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