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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 503904239
Report Date: 08/08/2022
Date Signed: 08/08/2022 02:49:26 PM

Document Has Been Signed on 08/08/2022 02:49 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
FRESNO-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:VASQUEZ, CONNIE FAMILY CHILD CAREFACILITY NUMBER:
503904239
ADMINISTRATOR:VASQUEZ, CONNIEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 537-4540
CITY:CERESSTATE: CAZIP CODE:
95307
CAPACITY: 14TOTAL ENROLLED CHILDREN: 26CENSUS: 10DATE:
08/08/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Connie VasquezTIME COMPLETED:
03:00 PM
NARRATIVE
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On 08/08/2022, Licensing Program Analyst (LPA) Jeovanna Yanez conducted an unannounced case management inspection. LPA met with Licensee, Connie Vasquez and a census was taken. The purpose of today’s inspection was to address incidents involving Staff #1, that the Department was made aware of.

On 05/26/2022, the Department was made aware of incidents involving Staff #1 in which the health, safety, and personal rights of children in care were alleged to have been violated. The Department investigated these incidents and discovered the allegations to have been UNSUBSTANTIATED. The Investigation also revealed that Licensee had known about these allegations against Staff #1, but did not report this information to the Department. LPA discussed reporting requirements with Licensee and the responsibility of the facility to report all unusual incidents to the Department within 24 hours of occurrence. CCR Section 102416.2(b) states, "The licensee shall report to the Department any of the events as specified in Health and Safety Code Sections 1597.467(b)(1)(A) through (b)(1)(C) that occur during the operation of the family child care home." In addition, Licensee was reminded that incidents are to be reported to the Department within 24 hours or by the next business day.

Per California Code of Regulations, Title 22, Division 12, Chapter 3, the following deficiency was found: (see LIC809-D). A copy of appeal rights were provided.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee, Connie Vasquez. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Jeovanna Yanez
LICENSING EVALUATOR SIGNATURE: DATE: 08/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/08/2022
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 08/08/2022 02:49 PM - It Cannot Be Edited


Created By: Jeovanna Yanez On 08/08/2022 at 02:19 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
, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: VASQUEZ, CONNIE FAMILY CHILD CARE
FACILITY NUMBER: 503904239

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/08/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/15/2022
Section Cited
CCR
102416.2(b)

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Reporting Requirements (b) The licensee shall report to the Department any of the events as specified in Health and Safety Code Sections 1597.467(b)(1)(A) through (b)(1)(C) that occur during the operation of the family child care home. This requirement was not met as evidenced by:
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Licensee was provided the Department’s website for videos for Family Child Care Providers. Licensee has agreed to watch CCLD video on Reporting Requirements, and submit a written statement acknowledging understanding of this regulation and how this regulation will be complied in the future.
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Information obtained through review of records and statements made by Licensee. This poses a potential risk to the health, safety, or personal rights of children in care.
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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:Juvenal Moctezuma
LICENSING EVALUATOR NAME:Jeovanna Yanez
LICENSING EVALUATOR SIGNATURE:
DATE: 08/08/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/08/2022


LIC809 (FAS) - (06/04)
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