198011890-7-10-2024-33-CC-MSIA-D72LNC-20240710085404

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198011890
Report Date: 07/09/2024
Date Signed: 07/10/2024 08:54:50 AM

Document Has Been Signed on 07/10/2024 08:54 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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	VAZQUEZ FAMILY CHILD CARE		FACILITY NUMBER:	198011890
ADMINISTRATOR/ DIRECTOR:	VAZQUEZ, MARTHA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(626) 812-9614
CITY:	AZUSA	STATE: CA	ZIP CODE:	91702
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 10	CENSUS: 4	DATE:	07/09/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	12:40 PM
MET WITH:	Licensee Martha Vazquez		TIME VISIT/ INSPECTION COMPLETED:	03:45 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA) Mary Silva conducted an unannounced annual required inspection at the above facility on 07/09/24. Licensing staff met with Licensee Martha Vazquez, who guided analyst on a tour of the facility. The Entrance Checklist LIC 126, was provided. Visit was conducted in Spanish. There were four children present upon arrival. Facility capacity is in compliance for a Large Family Child Care Home. Hours of operation are Monday-Sunday 6:00 AM - 5:00 AM. Currently residing in the home are three adults (criminal record clearance on file) and no minors. There was a total of three adults present during this inspection, licensee, assistant Bryan Esparza and assistant Brandon Ojeda. This is a single-story home with a second home in the lot. The second home in the premises has a separate address 144 N. Vernon Ave, Azusa CA 91702, per licensee home is empty and used as a storage place. The home consists of three bedrooms, three bathrooms, kitchen, living room, dining room, family room/daycare room, fenced front yard, side yard, fenced back yard and inground swimming pool. LPA observed the following required posted documentation in the main entry way of the facility: Facility License, Publication (PUB) 394- Notification of Parent Rights and Licensing Form (LIC) 9148- Earthquake Preparedness form. LPA reviewed facility records for LIC 9040- Facility Roster, LIC 610- Facility Disaster Plan and Disaster drill log. Last drill was conducted in June 2024 Per licensee areas off limits to children and parents include: 3 bedrooms, 2 bathrooms, kitchen, dining room, living room, front yard fenced back yard, swimming pool located in the back yard and second home located in the premises adjacent to the side yard. Per licensee areas accessible to children are: Family room/daycare, 1 bathroom located in the daycare room and the side front yard. _____________________________________Page 1________________________________

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Mary Silva
LICENSING EVALUATOR SIGNATURE:	DATE: 07/09/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2024

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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: VAZQUEZ FAMILY CHILD CARE	FACILITY NUMBER: 198011890
	VISIT DATE: 07/09/2024

NARRATIVE

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The home was observed to be clean and orderly, with central air and heating. Licensing staff observed the smoke detector and carbon monoxide to be in operable condition. Fire extinguisher indicates fully charged, with purchase receipt dated 10/06/23. Per Licensee, offers lunch, dinner, and snacks.

The home maintains telephone service via land line and cell phone. There are toys and other age-appropriate material available for children. Licensee provides transportation services for school age children. Licensing staff observed a fireplace in the living room barricaded making it inaccessible to children. LPA observed two dogs in the back yard, (large size Husky and Chihuahua breed). Reminded licensee pets must remain inaccessible to children during hours of operation.

Licensee states that there are no poisons stored in the home and understands that all poisons must be locked, to be made inaccessible to children. Per Licensee there are no firearms or weapons stored in the home. Licensing staff reminded licensee smoking is not allowed in the home.

The Licensee uses the side yard for outdoor play. The outdoor play area was observed to be fenced. Licensing staff observed the outdoor yard has toys and other materials for children to play with. LPA observed bodies of water were observed an inground swimming pool in the back yard with a self- latching gate which opens away from the swimming pool. The swimming pool has a black iron gate which is at least 5ft. The measurement from the hard concrete surface to the bottom of the fence is 3 inches, the openings between railings are 4.5 inches making swimming pool in compliance with Title 22 regulations. There is a door which leads to the back yard, the door always remains locked, and it has a second chain lock on the top.

Children’s records were reviewed for (LIC) 282- Affidavit Regarding Liability Insurance, Immunization's Records, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, and LIC 995A Notification of Parents’ Rights.

Staff and Licensee files were reviewed for the following: LIC 508- Criminal Record Statement, Proof of immunizations against measles, pertussis and influenza or influenza declination, TB clearance or risk assessment, LIC 9108- Statement Acknowledging Requirement to Report Child Abuse.
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SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Mary Silva
LICENSING EVALUATOR SIGNATURE:	DATE: 07/09/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2024

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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: VAZQUEZ FAMILY CHILD CARE	FACILITY NUMBER: 198011890
	VISIT DATE: 07/09/2024

NARRATIVE

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Pediatric First Aid and CPR certification expires on 12/03/25 for licensee, assistant Bryan Esparza and assistant Brandon Ojeda. Mandated Reporter Training expires on 08/03/2025 for licensee, assistant Bryan Esparza and assistant Brandon Ojeda. www.mandatedreporterca.com

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 an 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. Licensee currently does not have infants enrolled.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. 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: https://www.ada.gov/resources/child-care-centers/.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

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SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Mary Silva
LICENSING EVALUATOR SIGNATURE:	DATE: 07/09/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2024

LIC809 (FAS) - (06/04)

Page: 3 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: VAZQUEZ FAMILY CHILD CARE	FACILITY NUMBER: 198011890
	VISIT DATE: 07/09/2024

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MyChildCarePlan.org – Centers and Family Child Care Homes - Licensee, was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

Megan’s Law - Family Child Care Homes - During the exit interview, Licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

Based on Licensing staff observations and records review,no deficiencies are being cited, licensee is in compliance with California Code of Regulations Title 22.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. Appeal rights were given.

Exit interview conducted and report was reviewed with Licensee, Martha Vazquez.

__________________________Page 4__________________________

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Mary Silva
LICENSING EVALUATOR SIGNATURE:	DATE: 07/09/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2024

LIC809 (FAS) - (06/04)

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