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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376614893
Report Date: 10/31/2023
Date Signed: 10/31/2023 03:24:33 PM

Document Has Been Signed on 10/31/2023 03:24 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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:VAZQUEZ, PATRICIA FAMILY CHILD CAREFACILITY NUMBER:
376614893
ADMINISTRATOR:PATRICIA VAZQUEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 584-2246
CITY:SAN DIEGOSTATE: CAZIP CODE:
92105
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
10/31/2023
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
10:10 AM
MET WITH:Patricia VazquezTIME COMPLETED:
03:30 PM
NARRATIVE
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On October 31, 2023, at 10:10 AM, Licensing Program Analyst (LPA), Luigi Gargaro, conducted an unannounced annual required inspection and met with the licensee, Patricia Vazquez. LPA disclosed the purpose of the inspection and was granted entry into the facility by the Licensee. Nine (9) children and three (3) staff members including Ms. Vazquez and her two assistants Alejandra Ortiz and Bryan Orozco were present in the facility during this inspection. This facility is a one floor, three bedroom, three bathroom home. Licensee accompanied LPA inside and out of the facility during this inspection.

The following areas used for child care are: the main day care room immediately behind the day care entry door and the day care bathroom. The day care kitchen has a safety gate installed at its entrance but it is in place for when the licensee does not want children to enter the kitchen. It was inspected today and there were no accessible hazardous items so licensee may allow children in the area at her discretion including to pass through it to access the bathroom. Off limits areas are the remainder of the home. The rest of the home is made inaccessible with an installed safety gate that is in front of the entranceway that leads to the front portion of the home immediately off the kitchen.

The fire extinguisher, smoke detector, and carbon monoxide detector met requirements. All hazardous items were inaccessible to children. The licensee has toys, play equipment and materials available. The home has a fenced backyard available for outdoor activities. There is an unsecured child safety gate installed halfway in the yard that is in place to make the back portion of the yard inaccessible. As the gate is not secured, licensee will maintain direct supervision at all times when children are playing in the yard. No bodies of water observed on the premises during the inspection. Licensee stated there are no weapons in the home. A review of staff records on this date indicates that most facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions. Ms. Vazquez does have an adult daughter, Kimberly Orozco, who lives in the home who has not obtained Livescan fingerprint clearances.
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Luigi Gargaro
LICENSING EVALUATOR SIGNATURE: DATE: 10/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/31/2023
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 8
Document Has Been Signed on 10/31/2023 03:24 PM - It Cannot Be Edited


Created By: Luigi Gargaro On 10/31/2023 at 12:45 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
, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: VAZQUEZ, PATRICIA FAMILY CHILD CARE
FACILITY NUMBER: 376614893

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/31/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102370(k)
Criminal Record Clearance
(k) The licensee shall maintain documentation of criminal record clearances or criminal record exemptions of employees, volunteers that require fingerprinting and non-client adults residing in the facility.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on analyst observation and interview, the licensee did not comply with the section cited above as her adult daughter who lives in the home, Kimberly Orozco, has not submitted to Livescan fingerprinting which poses an immediate health, safety or personal rights risk to chidren in care.
POC Due Date: 11/01/2023
Plan of Correction
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Licensee was provided with a request for Livescan service form today and states will contact a local Livescan office to make an appointment for her daughter and contact analyst with the date and time information of the appointment by 11/01/23 to address/correct the deficiency.
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:Jason Garay
LICENSING EVALUATOR NAME:Luigi Gargaro
LICENSING EVALUATOR SIGNATURE:
DATE: 10/31/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/31/2023


LIC809 (FAS) - (06/04)
Page: 2 of 8
Document Has Been Signed on 10/31/2023 03:24 PM - It Cannot Be Edited


Created By: Luigi Gargaro On 10/31/2023 at 12:45 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
, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: VAZQUEZ, PATRICIA FAMILY CHILD CARE
FACILITY NUMBER: 376614893

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/31/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(j)(2)(B)
Infant Safe Sleep
The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall check and document the following: Signs of distress which includes but is not limited to flushed skin color, increase in body temperature and restlessness.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above as licensee has not been documenting the napping status of infants every 15 minutes as required by regulation which poses/posed a potential health, safety or personal rights risk to infants in care.
POC Due Date: 11/10/2023
Plan of Correction
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Licensee was unaware of the requirement to check on and document infants' napping status. Licensee was provided with a blank copy of a safe sleep log and states will immediately begin documenting their nap times and continue to do so as required. She states she will provide analyst a sample of the logs from two infants of her choice from 11/01/23-11/07/23 by 11/10/23 to complete the correction.
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above as neither she nor her two helpers had a current mandated reporter certification which poses/posed a potential health, safety or personal rights risk to children in care.
POC Due Date: 12/04/2023
Plan of Correction
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Licensee was provided with a mandated reporter training flyer that contains training information at www.mandatedreporterca.com and states she and her assistants will take the training and send analyst a copy of their completion certificates by 12/04/23 to complete the correction.
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:Jason Garay
LICENSING EVALUATOR NAME:Luigi Gargaro
LICENSING EVALUATOR SIGNATURE:
DATE: 10/31/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/31/2023


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/31/2023 03:24 PM - It Cannot Be Edited


Created By: Luigi Gargaro On 10/31/2023 at 12:45 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
, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: VAZQUEZ, PATRICIA FAMILY CHILD CARE
FACILITY NUMBER: 376614893

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/31/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.622(c)
Administration of Child Day Care Licensing
(c) The family day care home shall maintain documentation of the required immunizations or exemptions from immunization, as set forth in this section, in the person's personnel record that is maintained by the family day care home.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above as immunization records were not on file for her or her assistants which poses/posed a potential health, safety or personal rights risk to children in care.
POC Due Date: 12/04/2023
Plan of Correction
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Licensee states she will obtain copies of the immunization records demonstrating the required immunization for her and her assistants and submit them to analyst by 12/04/23 to complete the correction.
Type B
Section Cited
CCR
102418(a)
Immunizations
(a) Prior to admission to a family day care home, children shall be immunized against diseases as required by the California Code of Regulations, Title 17, beginning with Section 6000.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on analyst record review, the licensee did not comply with the section cited above as six of the nine children in care today did not have copies of their immunizations on file today which poses/posed a potential health, safety or personal rights risk to children in care.
POC Due Date: 11/06/2023
Plan of Correction
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Licensee stated that she will obtain copies of the the children's shot records from their parents and transfer them to the immunization blue cards as required and then send analyst a copy of the completed cards for three children of her choosing by 11/06/23 to correct the deficiency.
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:Jason Garay
LICENSING EVALUATOR NAME:Luigi Gargaro
LICENSING EVALUATOR SIGNATURE:
DATE: 10/31/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/31/2023


LIC809 (FAS) - (06/04)
Page: 4 of 8
Document Has Been Signed on 10/31/2023 03:24 PM - It Cannot Be Edited


Created By: Luigi Gargaro On 10/31/2023 at 12:45 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
, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: VAZQUEZ, PATRICIA FAMILY CHILD CARE
FACILITY NUMBER: 376614893

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/31/2023

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 record review, the licensee did not comply with the section cited above as an infant sleeping plan was not completed for any of the infants she has in care which poses/posed a potential health, safety or personal rights risk to infants in care.
POC Due Date: 11/06/2023
Plan of Correction
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Licensee was provided with a copy of the LIC 9227 form today and states she will have the parents complete them for each respective infant and submit copies of the completed forms to analyst by 11/06/23 to correct the deficiency.
Type B
Section Cited
CCR
102416.5(d)(1)
Staffing Ratio and Capacity
(d) For a Large Family Child Care Home, the maximum number of children for whom care may be provided at any one time when there is an assistant provider in the home, including children under age 10 who reside at the licensee's home and the assistant provider's children under age 10, shall be either: (1) Twelve children, no more than four of whom may be infants; or

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on analyst interview and record review, the licensee did not comply with the section cited above as she had five infants in care which poses/posed a potential health, safety or personal rights risk to children in care.
POC Due Date: 11/01/2023
Plan of Correction
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Violation was determined to not be an immediate risk as fifth infant in care is older infant and licensee had three adults caring for children. Licensee states she will contact analyst tomorrow, 11/01/23, with confirmation of which infant is to be disenrolled and contact information of parent to complete the correction.
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:Jason Garay
LICENSING EVALUATOR NAME:Luigi Gargaro
LICENSING EVALUATOR SIGNATURE:
DATE: 10/31/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/31/2023


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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: VAZQUEZ, PATRICIA FAMILY CHILD CARE
FACILITY NUMBER: 376614893
VISIT DATE: 10/31/2023
NARRATIVE
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Licensee’s and her helpers' First Aid and CPR certifications expire in April of 2024. Licensee and her assistants did not have their required immunizations on file today. Licensee and her assistants did not have current Mandated Reporter Training certifications on file. Facility roster is maintained and was reviewed. The last fire and disaster drills were conducted and documented on 08/23/23. There is one crib or play yard for each infant who is unable to climb out of the crib or play yard. Cribs or play yards are free from all loose articles and objects. Though the day care children nap under provider supervision in the day care room, the provider has not been maintaining safe sleep logs. An Individual Infant Sleeping Plan [LIC 9227 (3/20)] has not been maintained for each infant up to 12 months of age. The provider places infants up to 12 months of age on their backs for sleeping.

LPA provided and discussed the following: Report suspected child abuse and neglect, maintain children’s records according to regulation, post all required forms, and ensure that all adults residing or working in the home have criminal background clearances or exemptions. Licensee was reminded that corporal punishment, smoking, exersaucers, bouncy seats, walkers, and jumpers and/or similar equipment are not allowed in daycare. Licensee was also provided handouts with information regarding upcoming Safe Sleep Regulations/SIDS, Lead exposure and Shaken Baby Syndrome. LPA and Licensee discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov.

LPA discussed and provided Licensee with the following: child care advocates email address: childcareadvocatesprogram@dss.ca.gov . In addition, for general questions or questions regarding licensing requirements contact the Child Care Licensing Duty Line at (619) 767-2248. Unusual Incident Reports may be e-mailed to: SDIncidentReports@dss.ca.gov

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

One type A and six type B violations California Code of Regulations, (Title 22, Division 12 & Chapter 3), are being cited on the attached LIC 809-D.
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Luigi Gargaro
LICENSING EVALUATOR SIGNATURE:

DATE: 10/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/31/2023
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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: VAZQUEZ, PATRICIA FAMILY CHILD CARE
FACILITY NUMBER: 376614893
VISIT DATE: 10/31/2023
NARRATIVE
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Upon Receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months.

An exit interview was conducted with the licensee. The licensee was provided a copy of their appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights.

LPA provided notice of site visit and observed it being posted at the facility.
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Luigi Gargaro
LICENSING EVALUATOR SIGNATURE:

DATE: 10/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/31/2023
LIC809 (FAS) - (06/04)
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