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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376614893
Report Date: 06/02/2025
Date Signed: 06/02/2025 02:15:43 PM

Document Has Been Signed on 06/02/2025 02:15 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/
DIRECTOR:		PATRICIA VAZQUEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 584-2246
CITY:SAN DIEGOSTATE: CAZIP CODE:
92105
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 11DATE:
06/02/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Patricia VazquezTIME VISIT/
INSPECTION COMPLETED:
02:15 PM
NARRATIVE
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On June 2, 2025 at 10:00 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. Eleven (11) 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 a secured child safety gate installed halfway in the yard that is in place to make the back portion of the yard inaccessible. 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 all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions.
NAME OF LICENSING PROGRAM MANAGER: Jason Garay
NAME OF LICENSING PROGRAM ANALYST: Luigi Gargaro
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/02/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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Document Has Been Signed on 06/02/2025 02:15 PM - It Cannot Be Edited


Created By: Luigi Gargaro On 06/02/2025 at 12:32 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: 06/02/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
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 analyst interview and record review, the licensee did not comply with the section cited above as neither the licensee nor her assistants have current Mandated Reporter Training certifications which poses/posed a potential health, safety or personal rights risk to children in care.
POC Due Date: 07/07/2025
Plan of Correction
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Analyst provided licensee with a Mandated Reprter Training flyer that has information on the www.mandatedreporterca.com website where free training can be taken. Licensee states that she and her two helpers, Alejandra Ortiz and Bryan Orozco, will complete the training and send analyst a copy of their completed certificates by 07/07/25 to correct the deficiency.
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 children #1, #3, #6, #7 and #9 did not contain copies of immunization records in their files which poses/posed a potential health, safety or personal rights risk to children in care.
POC Due Date: 06/23/2025
Plan of Correction
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Licensee states she will request copies of immunization records from the parents of the children in question and then transfer them to the blue immunization cards provided to her during today's visit. Licensee will send copies of the completed shot cards for any of the three children listed of her choice to analyst by 06/23/25 to correct the deficiency. Child #1 also has no other records and licensee will send a copy of a complete packet for her 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.
Jason Garay
NAME OF LICENSING PROGRAM MANAGER:
Luigi Gargaro
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 06/02/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/02/2025


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 06/02/2025 02:15 PM - It Cannot Be Edited


Created By: Luigi Gargaro On 06/02/2025 at 12:32 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: 06/02/2025

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 analyst record review, the licensee did not comply with the section cited above as child #1, an eight month old infant, did not have an LiC 9227 completed for her which poses/posed a potential health, safety or personal rights risk to infants in care.
POC Due Date: 06/09/2025
Plan of Correction
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Analyst provided licensee with a blank LIC 9227 form for her to provide to the child's guardian to complete. Licensee states she will file the form in the child's record and send analyst a copy of signed and completed form by 06/09/25 to 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.
Jason Garay
NAME OF LICENSING PROGRAM MANAGER:
Luigi Gargaro
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 06/02/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/02/2025


LIC809 (FAS) - (06/04)
Page: 4 of 6
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: 06/02/2025
NARRATIVE
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Licensee’s and her helpers' First Aid and CPR certifications expire in 04/05/27. 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 03/21/25. 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. The provider physically checks on sleeping infants every 15 minutes. 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.

Four type B violations California Code of Regulations, (Title 22, Division 12 & Chapter 3), are being cited on
attached LIC 809-D.

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.

A notice of site visit was provided by the LPA and must remain posted for 30 days.
NAME OF LICENSING PROGRAM MANAGER: Jason Garay
NAME OF LICENSING PROGRAM ANALYST: Luigi Gargaro
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/02/2025
LIC809 (FAS) - (06/04)
Page: 5 of 6
Document Has Been Signed on 06/02/2025 02:15 PM - It Cannot Be Edited


Created By: Luigi Gargaro On 06/02/2025 at 01:19 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: 06/02/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.622(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

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 assistant, Alejandra Ortiz, which poses/posed a potential health, safety or personal rights risk to children in care.
POC Due Date: 06/30/2025
Plan of Correction
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Licensee states she will obtain copies of the vaccination records demonstrating the required immunizations for her and her assistant and submit them to analyst by 06/30/25 to complete the correction.
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.
Jason Garay
NAME OF LICENSING PROGRAM MANAGER:
Luigi Gargaro
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 06/02/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/02/2025


LIC809 (FAS) - (06/04)
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