197700420-3-9-2023-12-CC-AALH-CPS2QB-20230309163540

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197700420
Report Date: 03/09/2023
Date Signed: 03/09/2023 07:21:17 PM

Document Has Been Signed on 03/09/2023 07:21 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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME:	VASQUEZ FAMILY CHILD CARE		FACILITY NUMBER:	197700420
ADMINISTRATOR:	THERESA DE JESUS VASQUEZ		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(747) 218-7295
CITY:	PALMDALE	STATE: CA	ZIP CODE:	93551
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 9	DATE:	03/09/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:30 PM
MET WITH:	Licensee Theresa Vasquez		TIME COMPLETED:	05:00 PM

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On 03/09/23 Licensing Program Analyst (LPA) Andrew Alemoh, met with licensee, Theresa Vasquez who guided analyst on a tour of the facility for the One Year Required inspection. This is a two story home. Upon arrival LPA observed 9 children (4 infant) in care and 2 adults caring for them (Licensee and assistant #1). Family members residing in the home include 2 adults (licensee, licensee's husband, 3 minor children). Facility hours of operation are Monday - Friday 5:30AM- 6 PM. Incidental Medical Services (IMS) policy was discussed.

Physical Plant: Main care is provided in the baby room, and the play room for the older day care children There is a baby gate separating the two areas. The children use the bathroom located by the office on the right. The off-limits areas are all upstairs (barricaded by a baby gate), all bedrooms, second restroom, kitchen, and licensee office. The backyard is off limits, as well as the laundry room and garage are also off limits and are kept locked during business hours. 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 which are kept in the garage, medicines are kept in the off limits kitchen area and hazardous items (sharp knives are kept in the kitchen in the kitchen cabinet with a safety latch making it inaccessible to children) .

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE:	DATE: 03/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2023

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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: VASQUEZ FAMILY CHILD CARE	FACILITY NUMBER: 197700420
	VISIT DATE: 03/09/2023

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Safe and age appropriate toys, play equipment and materials were observed. The smoke detector, carbon monoxide detector and Fire Extinguisher (2A10BC) are all in operable condition. Electrical outlets are inaccessible. .

No recalled and or prohibited toys or sleep/ play equipment were observed on the premises. There is a designated area for ill children as necessary in the living room. Per Licensee, there are no weapon/firearms in the home. The facility sketch is complete and current, there is working telephone (cell).

Fire/Disaster drills are maintained current. Last fire disaster drill was completed on 10/10/22

Bathroom: LPA observed the toilet and faucet are clean and operable. There were no shampoos/shower gels or any prohibited items in the children bathroom.

Kitchen: The kitchen is off limits. LPA observed a baby gate barricading the kitchen area. Sharp utensils, open bottles or alcohol are inaccessible. The home has a clean and fully stocked refrigerator/freezer. Cleaning supplies are in the garage which is locked during business hours. Breakfast, lunch, snacks and dinner are provided. Licensee stated she currently does have a food program. Naps are provided on cots/cribs the baby room.

Outdoor: The front yard is off limits. Per licensee the right side of the backyard is off limits due to wall construction. LPA observed a baby gate barricading the right side of the backyard. On the left side of the backyard is black iron fence barricading the 2 covered BBQ pits and AC unit. AC unit is also covered. The backyard is completely fenced in with a brick walls.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE:	DATE: 03/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2023

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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: VASQUEZ FAMILY CHILD CARE	FACILITY NUMBER: 197700420
	VISIT DATE: 03/09/2023

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There is one dog in the premises. Per licensee, dogs do not come in contact when children are present. LPA observed age appropriate toys, well secured and safe for children.

There are no bodies of water in the premises.

Advisory/Other: First Aid kit was observed with supplies readily available. CPR/First Aid expired back on 02/23. Mandated Reporter expired back on 01/23 LPA reminded licensee; mandated reporter training must be completed every 2 years.

Documents Provided and or Discussed: Fire Drill Log, Postings, Employee's and Children's records, Safe Sleep PIN 20-24-CCP and Individual Sleeping Plan (LIC9227). Licensee currently does have child care insurance.

Licensee Theresa 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 Theresa 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. LPAs 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.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE:	DATE: 03/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2023

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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: VASQUEZ FAMILY CHILD CARE	FACILITY NUMBER: 197700420
	VISIT DATE: 03/09/2023

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The facility was cited type B deficiencies according to the California Code Title 22 Regulations (cite regulation).

Licensee First Aid/CPR has expired back on 02/23.

An exit interview was conducted, a copy of this report was reviewed and provided to licensee along with the appeal rights.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE:	DATE: 03/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 03/09/2023 07:21 PM - It Cannot Be Edited

Created By: Andrew Alemoh On 03/09/2023 at 04:16 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: VASQUEZ FAMILY CHILD CARE	FACILITY NUMBER: 197700420
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/09/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102416(c)

Personnel Requirements

(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866. 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 that Licensee CPR/First Aid Training expired on 02/23 which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/17/2023
	Plan of Correction
1 2 3 4	Licensee stated that she and her husband will renew their CPR/First Aid training before the POC date. Licensee will send proof of completetion no later than POC date .

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:

Mariela Ramon

LICENSING EVALUATOR NAME:

Andrew Alemoh

LICENSING EVALUATOR SIGNATURE:

DATE: 03/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2023

LIC809 (FAS) - (06/04)

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