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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444415939
Report Date: 12/08/2023
Date Signed: 12/08/2023 02:43:17 PM

Document Has Been Signed on 12/08/2023 02:43 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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:VASQUEZ, LORENAFACILITY NUMBER:
444415939
ADMINISTRATOR:LORENA VASQUEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 247-8372
CITY:WATSONVILLESTATE: CAZIP CODE:
95076
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: DATE:
12/08/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
01:40 PM
MET WITH:Lorena VasquezTIME COMPLETED:
03:15 PM
NARRATIVE
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Licensing Program Analysts (LPAs) Teodoro Trujillo and Liridon Fici met with Lorena Vasquez and explained the nature of visit to her. Present were adults, Estephania, Alma, Jesus Morales who has a licensed day care, licensee 12 year old daughter and 3 month old grandchild, two infants arrived during visit.

During the visit conducted 11/8/2023 at approximately 7:05 AM, the Licensee Lorena, allowed her 12 year old daughter to walk at minimum five school age children to the school bus stop without any adult supervision. LPA conducted interview with licensee and observed 12 year old daughter walking the children to the bus stop.

LPA advised Lorena that minors shall not transport/walk children to school. Children in care shall be supervised by an adult, meaning a person who is 18 years old or older. While the child was being transported to school, the child was under the supervision of a minor as no adults were present.

As a result of today's inspection, a deficiency has been cited, see LIC809-D
Type A deficiencies were cited during today's visit. LPA Teodoro Trujillo and Liridon Fici informed licensee Lorena Vasquez that this report dated 12/08/23 document(s) 1 (one) Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.
Also, LPAs Teodoro Trujillo and Liridon Fici informed the licensee Lorena Vasquez to provide a copy of this licensing report dated 12/082023 that documents any Type A citation(s) 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.

Exit interview conducted and report was reviewed with the Licensee, Lorena Vasquez.
SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Teodoro Trujillo
LICENSING EVALUATOR SIGNATURE: DATE: 12/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/08/2023
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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Document Has Been Signed on 12/08/2023 02:43 PM - It Cannot Be Edited


Created By: Teodoro Trujillo On 12/08/2023 at 01:56 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
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: VASQUEZ, LORENA
FACILITY NUMBER: 444415939

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/08/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/09/2023
Section Cited
CCR
102417(a)

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102417 Operation of a Family Child Care Home (a) The licensee shall be present in the home and shall ensure that children in care are supervised at all times. When circumstances require the licensee to be temporarily absent from the home, the licensee shall arrange for a substitute adult to care for and supervise the children during his/her absence...

This requirement was not met as evidenced by:
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The Licensee is to stop allowing the minor to transport children and will submit a list of all adults that will transport children. List of adults shall also include copy of drivers license and current First-Aid/CPR certifications.
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The Licensee and/or another adult did not transport a child to school and instead had 12 year old daughter walk with a minimum five school age children to the school bus stop without any adult supervision, which poses an immediate risk to the health, safety, and personal rights of children in care.
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Licensee will also submit a written statement of her understanding of CCR 102417(a) to the San Jose Regional office by 12/08/23.

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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:Susy Cervantes
LICENSING EVALUATOR NAME:Teodoro Trujillo
LICENSING EVALUATOR SIGNATURE:
DATE: 12/08/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/08/2023


LIC809 (FAS) - (06/04)
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