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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376630007
Report Date: 08/16/2024
Date Signed: 08/16/2024 11:32:43 AM

Document Has Been Signed on 08/16/2024 11:32 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:VELAZQUEZ ISLAS, VIANEY FAMILY CHILD CAREFACILITY NUMBER:
376630007
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 5DATE:
08/16/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:01 AM
MET WITH:Vianey VelazquezTIME VISIT/
INSPECTION COMPLETED:
11:45 AM
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On 08/16/2024 at 10:00 AM, Licensing Program Analyst (LPA) Dana Stevens conducted a case management inspection for the purpose of an increase in capacity. LPA met with the Licensee, Vianey Islas Velazquez and was granted entry into the facility. Licensee accompanied LPA on a tour of the inside and outside of the facility. Five (5) children ages 17 months to 5 years of age were present in the facility during this inspection. Licensee's spouse was also present and assisting with child care. This facility is a single story, 3 bedroom, 2 bathroom house. The following areas used for childcare are: Living Room, Kitchen, and Bathroom #1, hallway and backyard. Off-limit areas are, Bedrooms #1, #2 and #3, Bathroom #2, The backyard Lagoon (fenced within bodies of water regulations), Storage (backyard) and small areas on the left and right side of the home (backyard). There are child-proof locks or latches and gates to make the off-limit areas inaccessible to children in care. Because the applicant rents/leases the home, proof of landlord notification is required. The applicant obtained a signed Property Owner/Landlord Consent form (LIC 9149).

The fire extinguisher, smoke detector, and carbon monoxide detector met requirements. The licensee has toys, play equipment and materials available for children’s use. Licensee stated there are no weapons in the home. A review of records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions. Licensee’s and spouse's First Aid and CPR certifications expire on 10/2024. Licensee and spouse have required immunization. Licensee completed Mandated Reporter Training AB 1207 on 10/2023. Licensee's spouse completed Mandated Reporter Training on 01/2023. A sample of children's files were reviewed and found complete. The fire clearance for 14 children was granted/received on 07/30/2024. 
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Dana Stevens
LICENSING EVALUATOR SIGNATURE: DATE: 08/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/16/2024
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
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: VELAZQUEZ ISLAS, VIANEY FAMILY CHILD CARE
FACILITY NUMBER: 376630007
VISIT DATE: 08/16/2024
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Outdoor play activities will be conducted in back yard. The applicant has a Pond/Lagoon in the very back of the back yard that is fenced and gated within regulations. A five feet high fence enclosing the bodies of water, the fence does not obscure the lagoon from view. The gates swing away from the lagoon, is self-closing and has a self-latching device. The applicant provided a written statement confirming that no daycare children will be allowed access to the lagoon. Applicant has been notified that direct supervision is necessary at all times when daycare children have any access to the backyard and that the gate must remain securely closed and latched at all times when daycare children are present at the facility.

LPA discussed the maximum number of children for whom care shall be provided when there is an assistant provider in the home, including children under age 10 who live in the licensee's home and the assistant provider's children under age 10, shall be either: Twelve (12) children with no more than four of whom may be infants or Fourteen (14) children, with at least two of the children with 1 child enrolled in kindergarten and 1 child at least six years of age and no more than three infants.

Incidental Medical services (IMS) policy was discussed.
Licensee stated that Incident Medical Services are not being provided at this time. 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.

No deficiencies cited. No corrections are needed. A large license will be granted effective 08/16/2024.
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Dana Stevens
LICENSING EVALUATOR SIGNATURE:

DATE: 08/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2024
LIC809 (FAS) - (06/04)
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