<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198015575
Report Date: 03/28/2025
Date Signed: 03/28/2025 12:10:33 PM

Document Has Been Signed on 03/28/2025 12:10 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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:VASQUEZ FAMILY CHILD CAREFACILITY NUMBER:
198015575
ADMINISTRATOR/
DIRECTOR:		VASQUEZ, JOSEFAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 217-5720
CITY:SOUTH GATESTATE: CAZIP CODE:
90280
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 2DATE:
03/28/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:30 AM
MET WITH:Josefa VasquezTIME VISIT/
INSPECTION COMPLETED:
12:30 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) Peter Bishop arrived at the above facility for the purpose of an Unannounced/Annual Visit at 08:30 AM. Upon arrival, LPA announced the purpose of the visit and was granted entry into the facility by Licensee Josefa Vasquez who provided a tour of facility. LPA provided the inspection Entrance Checklist, LIC 126. LPA inspected rooms/areas on the facility sketch in which child-care services are being provided and to which children have access. LPA observed that the facility sketch has been changed and there is a new Main Care area. Per licensee, the current hours that care is provided are Monday-Friday 6:30 AM – 6:00 PM. No overnight care is not being provided at the time of the visit. There was 2 children present during today's inspection. Licensee states that there is a total of 14 enrolled. Licensee stated that her and her husband and two sons and two daughters live in the home. There is a valid background clearance on file. LPA observed the facility license, Publication (PUB) 394- Notification of Parent Rights and Licensing Form (LIC) 9148- Earthquake Preparedness forms. Licensee was advised to post the required documents on the parent board. Disaster drill log was available during today’s inspection and the last drill was conducted on 03/07/2025. Drills should be performed minimally every 6 months.

At 8:45 AM LPA Bishop was given a tour of the facility. This is a one-story home which consists of three bedrooms and two bathrooms, Kitchen, Living Room, Dining Room and outside play area which has age-appropriate toys, tables and cubbies. Per Licensee, areas off limits to children and parents include Bedrooms 1, 2, and 3. LPA observed the doors to be locked at time of inspection. Per licensee, off limit rooms are locked during operating hours.

1 of 4
NAME OF LICENSING PROGRAM MANAGER: Karen Chambers
NAME OF LICENSING PROGRAM ANALYST: Peter Bishop
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 03/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/28/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 9
California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
Page: 2 of 9
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: VASQUEZ FAMILY CHILD CARE
FACILITY NUMBER: 198015575
VISIT DATE: 03/28/2025
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
26
27
28
29
30
31
32
At 9:00 AM, life-saving devices were inspected throughout the home. The smoke detector is located above the entrance of the main care area. The carbon monoxide detector is in the hallway. All devices were tested and operable. The 2A 10 BC Fire extinguisher is located in the main care area and hung on the wall. The fire extinguisher is deemed in compliance with an expiration of 03/11/2026. Licensee was reminded that fire extinguisher needs to be serviced yearly. The home maintains telephone service via cell phone/LAN line.

At 10:00 AM, Living Room (main care area) The room has an activity table for at least 5 children. This room was equipped with 2 playpens and a kitchenette area to play. There was decorative pictures on the green wall as well.

At 10:15 AM, LPA observed the kitchen area. LPA observed knives that were in a drawer that was locked and inaccessible to children. There was not any cleaning supplies stored in an unsafe area. All cleaning supplies were in a locked cabinet out of the reach of children. LPA did not observe any other hazards in the kitchen area.

At 10:30 AM, LPA observed front yard for outdoor play. The outdoor play area was observed to be completely fenced. The outdoor play area has age-appropriate toys and a slide for children with a grassy area and the shade for the children has not been installed yet. Licensee stated that she is purchasing a new canopy and the outside play area is not being used due to the recent rearrangement of the Facility sketch. Licensee states she will send pictures upon completion.

At 10:45 AM, LPA observed the central air and heating system. Licensee stated that the do provide transportation. They pick up children only. There are no smokers that reside in the home per Licensee.

At 11:15 AM, LPA observed that the bathroom the children use is clean and free of floor hazards. There was toilet paper, hand-washing soap, and towels for the children. LPA did not observe any chemicals stored in the bathroom or under the sink.

Per Licensee there are no firearms or weapons stored in the home. LPA did not observe any firearms or weapons in the home. Licensee states that there are no bodies of water present. LPA did not observe any

2 of 4
NAME OF LICENSING PROGRAM MANAGER: Karen Chambers
NAME OF LICENSING PROGRAM ANALYST: Peter Bishop
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2025
LIC809 (FAS) - (06/04)
Page: 3 of 9
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: VASQUEZ FAMILY CHILD CARE
FACILITY NUMBER: 198015575
VISIT DATE: 03/28/2025
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
26
27
28
29
30
31
32
bodies of water on the premises. Licensee further states that she does have two dogs that are kept locked away from the children during operating hours.
At 10:50 AM, Staff records were reviewed for approved Pediatric First Aid and CPR certification. Valid CPR/First Aide was available at the time of inspection expiring at 03/04/2025 for Licensee and her Husband. Both CPR Certificates were observed to be expired and out of compliance. Licensee stated they would get their certificated renewed this weekend. LIC-501: Personnel Record, LIC 9052- Employee Rights, Proof of immunizations against measles, pertussis and influenza or influenza declination, TB clearance or risk assessment was available at the time of the visits. LIC 9108- Statement Acknowledging Requirement to Report Child Abuse is available and current Mandated Reporter Training Certificate was available for Licensee Vasquez with an expiration date of 07/2025. The Assistant did not have proof of Mandated Reporter Certificate available at the time of this visit. Licensee stated that they would complete the classes this weekend.

Children’s records were reviewed LIC 700 Identification and Emergency Information, LIC 627 Consent for Emergency Medical Treatment, LIC 995A Notification of Parents rights and Immunizations were current up to date. Infant safe sleep logs were not available for two of two infants.

The following information was discussed:
LPA discussed the safe sleep regulations with Licensee Vasquez and discussed the Child Care Licensing Safe Sleep. Also, webpage resources provided at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA P Bishop also informed Licensee Gordon 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.
The following were discussed:
Incidental Medical Services (IMS) 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
3 of 4
NAME OF LICENSING PROGRAM MANAGER: Karen Chambers
NAME OF LICENSING PROGRAM ANALYST: Peter Bishop
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2025
LIC809 (FAS) - (06/04)
Page: 9 of 9
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: VASQUEZ FAMILY CHILD CARE
FACILITY NUMBER: 198015575
VISIT DATE: 03/28/2025
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
26
27
28
29
30
31
32
Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

Criminal Record Clearance - Family Child Care Homes – Licensee Vasquez 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.

Licensee Vasquez 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.

Based on the LPA P Bishops observations, record review, and interviews, there will be 1 deficiency, and 3 Technical Violation cited today in accordance with California Title 22 Regulations.

During the exit interview, the licensee, confirmed that there are no Registered Sex Offenders (RSO) living in the facility and LPA P Bishop completed the RSO search in Megan’s Law Website.

Based on this information, the following deficiencies on the attached LIC 809D are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site inspection by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00. Exit interview was conducted and report was reviewed with the Licensee Vasquez. Appeal rights were given as well.

4 of 4
NAME OF LICENSING PROGRAM MANAGER: Karen Chambers
NAME OF LICENSING PROGRAM ANALYST: Peter Bishop
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2025
LIC809 (FAS) - (06/04)
Page: 4 of 9
Document Has Been Signed on 03/28/2025 12:10 PM - It Cannot Be Edited


Created By: Peter Bishop On 03/28/2025 at 11:35 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
, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: VASQUEZ FAMILY CHILD CARE
FACILITY NUMBER: 198015575

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/28/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416.3(a)(6)
Alterations to Existing Building or Grounds
(a) Prior to making alterations or additions to a family child care home or grounds, the licensee shall notify the Department of the proposed changed, including, but not limited to, the following: (6) Any change from an area of the family child care home previously identified as "off limits" to an area where care and supervision will be provided to children in care.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation the licensee did not comply with the section cited above in one out of one Licensee did not report the changes made to the FCCH which posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/11/2025
Plan of Correction
1
2
3
4
Licensee will write a letter stating that she acknowledges she is required to report any and all changesmade to the home and where care is taking place.
Section Cited
Deficient Practice Statement
1
2
3
4
POC Due Date:
Plan of Correction
1
2
3
4
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Karen Chambers
NAME OF LICENSING PROGRAM MANAGER:
Peter Bishop
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 03/28/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/28/2025


LIC809 (FAS) - (06/04)
Page: 5 of 9