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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334842174
Report Date: 05/09/2023
Date Signed: 05/09/2023 10:59:50 AM

Document Has Been Signed on 05/09/2023 10:59 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SOUTH EAST, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:VEA FAMILY CHILD CAREFACILITY NUMBER:
334842174
ADMINISTRATOR:VEA, ZAIRAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(951) 443-4184
CITY:PERRISSTATE: CAZIP CODE:
92570
CAPACITY: 14TOTAL ENROLLED CHILDREN: 13CENSUS: 5DATE:
05/09/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:34 AM
MET WITH:Zaira VeaTIME COMPLETED:
11:05 AM
NARRATIVE
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Licensing Program Analysts (LPAs) Ana Noble arrived at the facility on a case management inspection to follow-up on an Unusual Incident Report (UIR) which occurred on March 9, 2023 per Licensee. LPA met with Zaira Vea, Licensee and provided purpose of inspection. At the time of inspection, LPA toured the facility, took census, and reviewed documents previously submitted to the department with Mrs. Vea, Licensee.

During the course of the investigation and self reported by the Licensee, that on March 9, 2023, one of the Licensee's dogs bite Child #1 (C1), in which it broke skin and caused the child to bleed. C1 was seen by a physician and treated for this incident.

LPA interviewed Licensee and C1 parent, who self disclosed that the incident reported in fact took place and C1 was biten by Licensee's dog, in which a C1 required medical attention.

Based on information obtain there is a violation of California Code of Regulations, Title 22, See LIC809D for cited deficiency of the Personal Rights.

An exit interview was conducted, and this report was reviewed with Zaira Vea, Licensee. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Ana Noble
LICENSING EVALUATOR SIGNATURE: DATE: 05/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/09/2023
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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Document Has Been Signed on 05/09/2023 10:59 AM - It Cannot Be Edited


Created By: Ana Noble On 05/09/2023 at 09:35 AM
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
, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: VEA FAMILY CHILD CARE
FACILITY NUMBER: 334842174

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/09/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/12/2023
Section Cited
CCR
102423(a)(2)

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Personal Rights To receive safe, healthful, and comfortable accommodations, furnishings, and equipment. This requirement was not met as evidenced by: Licensee self disclosed that on 3/9/23, Child 1(C1) was bitten by Licensee dog that required C1 to receive medical attention from a physician.
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Licensee has agreed to submit a written plan on how she will prevent the children from having access to the dogs during daycare hours of operation. Submit this plan to the Department by 5/12/2023.

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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:Deborah Mullen
LICENSING EVALUATOR NAME:Ana Noble
LICENSING EVALUATOR SIGNATURE:
DATE: 05/09/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/09/2023


LIC809 (FAS) - (06/04)
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