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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444406638
Report Date: 06/23/2023
Date Signed: 06/27/2023 04:15:26 PM

Document Has Been Signed on 06/27/2023 04:15 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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:VASQUEZ, TERESAFACILITY NUMBER:
444406638
ADMINISTRATOR:TERESA VASQUEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 724-4283
CITY:WATSONVILLESTATE: CAZIP CODE:
95076
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 6DATE:
06/23/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Teresa VasquezTIME COMPLETED:
03:45 PM
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Licensing Program Analyst (LPA) Elizabeth Berumen conducted an unannounced 1 year required inspection. LPA met with Licensee, Teresa Vasquez, and explained the nature of today's visit. Also present in the home were 5 day care children (1 infant and 4 preschoolers and one school age) 12 year old grandson and her assistant (Araceli Rocha). Teresa states her hours of operation are from Monday to Friday from 6:00 AM to 6:00 PM. Teresa states there are five adults living in the home, herself, her husband (Andres Vasquez), daughters (Blanca Vasquez), (Perla Vasquez) (Alondra Vasquez) her father (David Flores).

LPA notes that entrance to the day care is through the left side of the house. LPA inspected on limit indoor and outdoor areas of the home. Off limit areas in the home are 2 bedrooms, living room, dining room, garage and entire upstairs (two bedrooms and one bathroom). Off limit areas outside: storage shed and portion of the backyard. Children use the left side of the yard as play space. The outdoor area for children is safe and fenced. The fire place in day care room area is barricaded.

LPA observed a 3A40BC fire extinguisher that was serviced on 06/06/2023. The smoke and carbon monoxide detectors were tested and proved to be functioning. Licensee states there are no weapons in the home. Cleaning supplies, sharp objects, medications are stored inaccessible to children. LPA reviewed facility roster and obtained a copy. LPA reviewed the fire/disaster drill log; last documented fire drill was 06/06/23 and last earthquake drill was 06/13/2023.
LPA reviewed five children files today all were complete. LPA reviewed Assistant (Araceli Rocha) file; she completed the Mandated Reporter Training on March 12, 2022. Has valid CPR & First aid expiring 03/03/25, has LIC9052, TB, copy of driver license, immunization against pertussis, measles, and declined the flu vaccine on 09/26/22. Licensee's CPR & First aid is valid and expires on 02/10/25. Mandated Reporter Training was completed on March 14, 2022.
SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Elizabeth Berumen
LICENSING EVALUATOR SIGNATURE: DATE: 06/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/23/2023
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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: VASQUEZ, TERESA
FACILITY NUMBER: 444406638
VISIT DATE: 06/23/2023
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Licensee states that she provides meals (snacks and lunch) to the day care children. Licensee understands that any food brought from home shall be labeled with each child's name and properly stored. Licensee understands that smoking is prohibited in the home. Licensee states that she does not administer any medications to the day care children at this time. Licensee states that a child will be isolated in an area of the day care room.

Supervision of children was discussed with the Licensee and she understands that she must be present in the home during day care hours and ensure that the children are supervised at all times. Licensee understands her capacity/ratio options. Licensee states that does not transport day care children. She understands that children shall not be left unattended in parked vehicles. Licensee understands that car seats shall only be used for transportation and shall not be used for sleeping.

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.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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

Exit interview conducted and report was reviewed with the Licensee, Teresa Vasquez. No deficiencies issued during today's inspection.

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

SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Elizabeth Berumen
LICENSING EVALUATOR SIGNATURE:

DATE: 06/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2023
LIC809 (FAS) - (06/04)
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