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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 376628595
Report Date: 03/17/2023
Date Signed: 03/18/2023 07:23:43 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/13/2023 and conducted by Evaluator Cindy Meier
COMPLAINT CONTROL NUMBER: 20-CC-20230113124947
FACILITY NAME:VAZQUEZ, MARIA & OSCAR FAMILY CHILD CAREFACILITY NUMBER:
376628595
ADMINISTRATOR:MARIA & OSCAR V.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 799-7342
CITY:SAN DIEGOSTATE: CAZIP CODE:
92113
CAPACITY:14CENSUS: 4DATE:
03/17/2023
UNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Maria and Oscar VazquezTIME COMPLETED:
03:35 PM
ALLEGATION(S):
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Provider is not documenting infant's sleep on sleep log.
INVESTIGATION FINDINGS:
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On 03/17/23 at 3:00p.m. Licensing Program Analyst (LPA), Cindy Meier conducted an unannounced complaint inspection to deliver the findings of the above allegation. LPA met with Co-Licensees, Maria and Oscar Vazquez and advised Co-Licensees of the purpose of the inspection and conducted a tour of the facility. Present during the inspection were one (1) infant, three (3) preschoolers and co-licensees.

During the course of the investigation, interviews were conducted with the co-licensee, representative from outside agency, and day care parents. Children were not interviewed, as those enrolled are non-verbal infants. Facility records were obtained and reviewed by LPA.

Based on interviews and records reviewed, it was determined that the licensees did not maintain an infant sleep log until 01/13/23. Facility records indicate four (4) infant
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Cindy Meier
LICENSING EVALUATOR SIGNATURE:

DATE: 03/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 20-CC-20230113124947
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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, MARIA & OSCAR FAMILY CHILD CARE
FACILITY NUMBER: 376628595
VISIT DATE: 03/17/2023
NARRATIVE
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children have been enrolled for over six (6) months. Co-licensees stated they visually observe infants sleeping but admitted to not documenting the infant checks on a log until 01/13/23. The LPA discussed with the licensee the importance of ensuring the Infant Safe Sleep Regulation Section 102425(j)(2), be implemented in that, the provider shall supervise infants while they are sleeping and physically check on the infant every fifteen (15) minutes and document the findings. Co-licensees stated they understood.

Based on interviews which were conducted, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. Per California Code of Regulations, (Title 22, Division 12 & Chapter 3), one (1) Type B deficiency is being cited on the attached LIC 9099D.

Exit interview conducted and report was reviewed with co-licensees, Maria and Oscar Vazquez. A copy of this report, along with Appeal Rights (LIC9058), were provided. A Notice of Site Visit was given and must remain posted for 30 days. LPA observed that the Notice of Site Visit was posted during the inspection. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Cindy Meier
LICENSING EVALUATOR SIGNATURE:

DATE: 03/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 20-CC-20230113124947
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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, MARIA & OSCAR FAMILY CHILD CARE
FACILITY NUMBER: 376628595
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/17/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/17/2023
Section Cited
CCR
102425(j)(2)(D)
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(j) The provider shall supervise infants while they are sleeping and adhere to the following requirements: (2) The provider shall check and document…(1) Documentation shall be maintained in the infant’s file and be available to the Department for review…

This requirement is not met as evidenced by:

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Co-Licensees were provided a sample Safe Sleep log and stated they will begin documenting infants sleeping status every 15 minutes. The Co-Licensees will send a copy of the completed log for the dates of 3/17/23 - 3/22/23 to CCLD by 3/24/23.
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Based on interview and record review, the licensee did not comply with the section cited above in that three (3) out of three (3) infants did not have a record where licensee documented the physical checks of the sleeping infants every 15 minutes which poses/posed a potential health, safety, or personal rights risk to persons in care.

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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.
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Cindy Meier
LICENSING EVALUATOR SIGNATURE:

DATE: 03/17/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3