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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426216217
Report Date: 02/10/2023
Date Signed: 02/10/2023 12:17:40 PM

Document Has Been Signed on 02/10/2023 12:17 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, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:VAZQUEZ FCC AKA BIG BROTHER DAY CAREFACILITY NUMBER:
426216217
ADMINISTRATOR:ROBERTO DE JESUS VAZQUEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 863-8218
CITY:SANTA MARIASTATE: CAZIP CODE:
93454
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 2DATE:
02/10/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Roberto De Jesus VazquezTIME COMPLETED:
11:30 AM
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On 2/10/23, at 9:15 AM, Licensing Program Analyst (LPA) Elvin Baddley conducted an unannounced One Year Required Inspection of the abovementioned Family Child Care Home (FCCH). LPA met with Roberto De Jesus Vazquez, Licensee of the FCCH. LPA explained the purpose of the inspection and toured the exterior and interior of the FCCH with the Licensee. The FCCH is a five bedroom, three bathroom, single story dwelling. The FCCH's living room, kitchen, guest room (2), dining room, bathroom and backyard are used for child care services, while the remainder of the home is excluded from care. At the time of the inspection two children are present, along with an Assistant (cleared and associated) providing care and supervision.

The home is orderly, clean and void of hazardous items. Cleaning compounds (atop refrigerator), sharps (cabinet shelf) and medications (cabinet shelf) are stored in elevated locations in the kitchen which are beyond the reach of children in care. Toys, furniture and equipment observed in the FCCH are age appropriate. LPA observed a fireplace is in an exclude area of the FCCH. The fireplace is covered by a child safety gate. LPA observed required licensing forms and documents posted on the wall in the living room. LPA observed combination smoke/carbon monoxide detectors throughout the FCCH. LPA tested a combination smoke/carbon monoxide detector mounted in the dining room at 10:05 AM and found the detector to be operable. The FCCH has a regulation fire extinguisher (2A10BC )which was last serviced on 8/29/22. LPA reminded the Licensee to either service or purchase a regulation fire extinguisher annually. LPA reviewed the home’s fire/disaster drill log and observed the last fire/disaster drill occurred on 10/1/22.

The backyard of the FCCH is enclosed by wooden fencing and the entry/exit gates are secure. The footing in the area is varied. LPA observed a shed in the backyard area which contained equipment, tools and household supplies. The shed's door is secure. Toys and equipment observed in the backyard area are age appropriate. LPA observed no bodies of water on site.

LPA reviewed children records. The records were current and complete. A current roster of children was

(CONT. 809-C, Page 2)

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE: DATE: 02/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/10/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: VAZQUEZ FCC AKA BIG BROTHER DAY CARE
FACILITY NUMBER: 426216217
VISIT DATE: 02/10/2023
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reviewed by the LPA. The FCCH had documentation capturing children's sleep in 15 minute intervals and well as emergency contact information. The Licensee's records are also current and complete with Pediatric CPR and First Aid certifications expiring on 11/18/23. Mandated Reporter training was completed on 12/7/22. Licensee informed the LPA no firearms or ammunition are stored on site.

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



Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with Licensee 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 for additional resource. LPA also informed Licensee 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.

A Notice of Site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Licensee Roberto De Jesus Vazquez.

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE:

DATE: 02/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2023
LIC809 (FAS) - (06/04)
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