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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376628595
Report Date: 01/27/2023
Date Signed: 01/30/2023 08:06:50 AM

Document Has Been Signed on 01/30/2023 08:06 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
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
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: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 2DATE:
01/27/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Maria and Oscar VazquezTIME COMPLETED:
12:45 PM
NARRATIVE
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On 01/27/23 at 11:15 a.m. Licensing Program Analyst (LPA) Cindy Meier conducted a case management inspection at the facility. Upon arrival, LPA met with co-licensees Maria and Oscar Vazquez and discussed the purpose of the inspection was to deliver citations and was led on a tour of the facility. Co-licensee Oscar Vazquez provided translation for co-licensee Maria during the inspection.

During an unannounced complaint inspection on 1/19/23 it was determined that the co-licensees were out of compliance in that LPA reviewed four (4) out of four (4) children’s records that were incomplete. LPA observed two (2) play yards with two (2) infants sleeping, containing loose articles and objects. Child Care Facility Roster (LIC9040) and Co-licensees Mandated Reporter Training certificate was not available for review.

Per California Code of Regulations, (Title 22, division 12 & Chapter 3) one (1) Type A citation, and three (3) Type B citations are being cited on the attached LIC 809-D.

LPA Cindy Meier informed Co-Licensees, Maria and Oscar Vazquez that this report dated 1/27/23 document(s) (1) Type A citation which shall be posted for 30 consecutive days as there is immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Cindy Meier informed the Co-Licensees, Maria and Oscar Vazquez to provide a copy of this licensing report dated 1/27/23 that documents Type A citation 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.
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Cindy Meier
LICENSING EVALUATOR SIGNATURE: DATE: 01/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/27/2023
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
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: 01/27/2023
NARRATIVE
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LPA discussed the safe sleep regulations with co-licensees and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed co-licensees of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

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: 01/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2023
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 01/30/2023 08:06 AM - It Cannot Be Edited


Created By: Cindy Meier On 01/27/2023 at 09:37 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
, 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: 01/27/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/27/2023
Section Cited
CCR
102425(b)

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(b) Cribs or play yards shall be free from all loose articles and objects.

This requirement is not met as evidenced by:
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Co-licensee immediately cleared all loose items and articles from infant play yards. Co-Licensees stated they will review Safe Sleep Regulations, PIN 20-24 CCP, Safe Sleep FAQ's from June 2021, Safe Sleep Environment brochure and submit a written summary to CCLD by 2/10/23.
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Based on LPA observations, Co-Licensees did not ensure that play yards were free from loose articles and objects in that two (2) out of two (2) play yards contained loose articles, while infants were sleeping, which poses an immediate risk to the health and safety of children 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.
SUPERVISOR'S NAME:Jason Garay
LICENSING EVALUATOR NAME:Cindy Meier
LICENSING EVALUATOR SIGNATURE:
DATE: 01/27/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/27/2023


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 01/30/2023 08:06 AM - It Cannot Be Edited


Created By: Cindy Meier On 01/27/2023 at 09:41 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
, 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: 01/27/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/27/2023
Section Cited
CCR
102417(g)(8)

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(8) Each family childcare home shall have a current roster of children as specified in Health and Safety Code Section 1596.841.
This requirement is not met as evidenced by:
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LPA provided co-licensees with a blank facility roster LIC9040 during today's visit. Co-Licensees state that they will fill out the roster listing all the children in care and their
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Based on LPA record review, the co-licensees did not comply with the section cited above as it was determined that co-licensees are not maintaining a facility roster which poses/posed a potential health, safety, or personal rights risk to children in care.
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corresponding required personal information and submit a copy of the completed roster to CCLD by 01/31/23 to complete the correction.
Type B
01/27/2023
Section Cited
CCR102417(g)(7)

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(7) An emergency information card shall be maintained for each child and shall include the child's full name, telephone number and location of a parent or other responsible adult to be contacted in an emergency, the name and telephone number of the child's physician and the parent's authorization for the licensee or registrant to consent to emergency medical care.
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LPA provided co-licensees with a blank children’s records packet to provide to parents to complete and return for the children in care. LPA also provided co-licensees with the form LIC311D which lists required forms for
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This requirement is not met as evidenced by:
Based on LPA record review, the co-licensees did not comply with the section cited above in that four (4) out of four (4) children’s files were incomplete and did not contain the required forms for children in care which poses/posed a potential health, safety, or personal rights risk to children in care.
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children’s files. Co-licensees will submit copies of children’s completed forms to CCLD by 2/10/23 to demonstrate appropriate record keeping practices for children in care.
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:Cindy Meier
LICENSING EVALUATOR SIGNATURE:
DATE: 01/27/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/27/2023


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 01/30/2023 08:06 AM - It Cannot Be Edited


Created By: Cindy Meier On 01/27/2023 at 09:48 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
, 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: 01/27/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/27/2023
Section Cited
HSC
1596.8662

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(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
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Co-Licensee stated she will send completed Mandated Reporter Training AB1207 certificate to the San Diego Child Care Regional Office (SDCCRO) as proof of correction by the due date of 1/31/2023.
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provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years.....
This requirement is not met as evidenced by:
Based on record review, the Co-Licensee did not comply with the section cited above in that Co-Licensee’s Mandated Reporter Training was not available for review which poses 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.
SUPERVISOR'S NAME:Jason Garay
LICENSING EVALUATOR NAME:Cindy Meier
LICENSING EVALUATOR SIGNATURE:
DATE: 01/27/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/27/2023


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