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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198000309
Report Date: 03/11/2025
Date Signed: 03/11/2025 04:34:26 PM

Document Has Been Signed on 03/11/2025 04:34 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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:VANCE FAMILY DAY CAREFACILITY NUMBER:
198000309
ADMINISTRATOR/
DIRECTOR:		VANCE, SCHERIE P.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 324-3865
CITY:CARSONSTATE: CAZIP CODE:
90746
CAPACITY: 14TOTAL ENROLLED CHILDREN: 8CENSUS: 6DATE:
03/11/2025
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:25 PM
MET WITH:VANCE, SCHERIE / LicenseeTIME VISIT/
INSPECTION COMPLETED:
04:45 PM
NARRATIVE
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On 3/11/25 at 1:30 pm Licensing Program Analyst (LPA) Ashley Calderon arrived at the facility for the purpose of conducting Case Management Annual Continuation. LPA met with Licensee Scheire Vance who granted LPA entrance to the facility. LPA disclosed the purpose of todays visit.

LPA Calderon conducted a tour of the facility. LPA Calderon at 1:32pm observed 3 children in day care room upon arrival, Infant #1 was observed in play-pin sleeping on their stomach, deficiency cited and Licensee did not have the Infant Sleeping Plan LIC9227 for Infant #1, deficiency cited.

Knives are kept in an inaccessible cabinet that has a baby safety latch located on the Stove Oven Island in Kitchen. Per Licensee, keeps poisons in the garage. LPA observed chemicals and cleaning solutions stored in the cabinet under kitchen sink that has baby safety latches to provide inaccessibility.

At 1:39pm LPA observed Fire Extinguisher 2A10BC with inspection tag not serviced within a year. Tag is dated November 2, 2022 and observed another Fire Extinguisher classified as 1A10BC not meeting the required Fire Marshall State Regulation. Licensee stated will have to get fire extinguished updated and serviced, deficiency cited

At approximately 1:45pm Staff Assistant and 3 school age children arrived at the facility. During todays visit LPA reviewed staff and children's records. LPA reviewed current Children Roster- LIC9040 and Fire/ Disaster Drill Log with drill conducted on 2/10/25. LPA reviewed Licensee and Staff Assistants file. Licensee transports School Age Children. Staff assistants picks up after school children from near by school. Staff assistant Pediatric CPR, First Aid and Mandated Reporter is current and valid. Licensee Vance Mandated Reported Expires 6/6/2024 and Pediatric First Aid and CPR expires:10/01/26, all appropriate documentation's were in staff files. Staff interview with Licensee was conducted. (cont..)
SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Ashley Calderon
LICENSING EVALUATOR SIGNATURE: DATE: 03/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/11/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: VANCE FAMILY DAY CARE
FACILITY NUMBER: 198000309
VISIT DATE: 03/11/2025
NARRATIVE
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 LPA reviewed (5) children records, Infant #1 had there 15 min Sleep Log. LPA consulted with Licensee regarding record keeping /children's files, children had required documentation's in files.

Fire place was observed screened, in the living room and den located by the kitchen has a fireplace that does not generate heat. Carbon Monoxide and Smoke Alarm are interconnected was tested and found operable located in kitchen/dining room area.

Based on this information the following deficiencies on the LIC 809 D are being cited today 3/11/25.

LPA Ashley Calderon informed licensee Scherie Vance that this report dated 03/11/25 document(s), one (1) Type A citation which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care. Also, LPA Calderon informed the licensee to provide a copy of this licensing report dated 03/11/25 that documents any Type A citations to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.


A Notice of Site Visit was given and must be posted for 30 days. An exit interview was conducted with Licensee Scherie Vance and appeal rights were provided.

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Ashley Calderon
LICENSING EVALUATOR SIGNATURE:

DATE: 03/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2025
LIC809 (FAS) - (06/04)
Page: 2 of 5
Document Has Been Signed on 03/11/2025 04:34 PM - It Cannot Be Edited


Created By: Ashley Calderon On 03/11/2025 at 03:44 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
, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: VANCE FAMILY DAY CARE
FACILITY NUMBER: 198000309

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/11/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(c)
Infant Safe Sleep
An Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be completed for each infant up to 12 months of age the provider has in care and included in the infant's file at the facility.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation Infant #1 at 1:32pm laying on their stomach, interview with Licensee stated child rolled on their own and does not have LIC9227 Individual safe sleeping plan in file and unable to provide form to LPA Calderon, the licensee did not comply with the section cited above in [count] out of [total count] [(objects) (persons)] [identifiers] which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/17/2025
Plan of Correction
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Licensee will have infant #1 parent sign the LIC9227 Individual safe sleeping plan and email to LPA Calderon on their back.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Denise Gibbs
LICENSING EVALUATOR NAME:Ashley Calderon
LICENSING EVALUATOR SIGNATURE:
DATE: 03/11/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/11/2025


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 03/11/2025 04:34 PM - It Cannot Be Edited


Created By: Ashley Calderon On 03/11/2025 at 04:20 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
, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: VANCE FAMILY DAY CARE
FACILITY NUMBER: 198000309

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/11/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.46
(f) These standards shall apply uniformly throughout the state and shall include, but not be limited to: (1) the requirement that a large family day care home contain a fire extinguisher or smoke detector device, or both, that meets standards established by the State Fire Marshal.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation fire extinguisher had expired service tag dated 11/2/22 and another fire extinguisher classified as 1A10BC, the licensee did not comply with the section cited above in [1] out of [1] fire extinguisher device which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/21/2025
Plan of Correction
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Licensee will provide 2A10BC picture of fire extinguisher and proof of service tag and or receipt purchased within 1 year of today's date. Picture will be sent to LPA Calderon via telephonically by poc due date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Denise Gibbs
LICENSING EVALUATOR NAME:Ashley Calderon
LICENSING EVALUATOR SIGNATURE:
DATE: 03/11/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/11/2025


LIC809 (FAS) - (06/04)
Page: 5 of 5
Document Has Been Signed on 03/11/2025 04:34 PM - It Cannot Be Edited


Created By: Ashley Calderon On 03/11/2025 at 04:26 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
, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: VANCE FAMILY DAY CARE
FACILITY NUMBER: 198000309

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/11/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102425(d)
(d) The provider shall place infants up to 12 month of age on their backs for sleeping.


This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA Calderon observation Infant #1 at 1:32pm laying on their stomach, interview with Licensee stated child rolled on their own and does not have LIC9227 Individual safe sleeping plan in file , the licensee did not comply with the section cited above in [1] out of [1] infant child #1 ,which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 03/12/2025
Plan of Correction
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LPA Calderon provided CCLD Safe Sleep plan link to Licensee Vance, will review and write a declaration letter LIC855 stating 3 facts they know regarding Infant Safe Sleep and stating child needs to be on the back under age of 12 months and have LIC9227 Indiv. Safe Sleep Plan. Will submit Declaration to LPA Calderon by POC due date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Denise Gibbs
LICENSING EVALUATOR NAME:Ashley Calderon
LICENSING EVALUATOR SIGNATURE:
DATE: 03/11/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/11/2025


LIC809 (FAS) - (06/04)
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