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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197415024
Report Date: 11/22/2022
Date Signed: 11/22/2022 03:18:28 PM

Document Has Been Signed on 11/22/2022 03:18 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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:DIAZ FAMILY CHILD CAREFACILITY NUMBER:
197415024
ADMINISTRATOR:ERICKA DIAZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 718-3081
CITY:QUARTZ HILLSSTATE: CAZIP CODE:
93536
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 1DATE:
11/22/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:55 PM
MET WITH:Ericka Diaz, LicenseeTIME COMPLETED:
03:40 PM
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On 11/22/22 Licensing Program Analysts (LPAs) Justeene Tamayo and Annelise Villa met with Licensee, Ericka Diaz, who guided analyst on a tour of the facility for the One Year Required inspection. This is a one story, 4 bedroom, 3 bathroom home with kitchen/dining, family room, living room, laundry room and converted garage (day care area). There is a pool/spa or body of water on the premises. Upon arrival LPA observed 1 child in care. Licensee currently does not have any infants in care but does understand the requirements. Family members residing in the home include 4 adults (licensee, licensee's husband, adult son, adult daughter) and no children. Facility operation are Monday-Friday 6:30AM-6PM. Incidental Medical Services (IMS) policy was discussed.

Physical Plant: Main care is provided in the converted garage(day care area). Children use the bathroom on the right side in the main care area. Children have access to the day care area (converted garage). Off limit areas include all bedrooms, bathrooms #2 and #3, living room, kitchen, dining room, and laundry room. LPAs observed a door leading to the rest of the house from the main care area which is off limits. The home was inspected inside and out for safety, clean and orderly, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds (in upper cabinet with magnet lock), medicines (master bedroom in off limit area) and hazardous items (sharp knives in kitchen (off limits)) that can pose a danger to children. The fireplace is in the off limits area. Safe and age appropriate toys, play equipment and materials were observed. The smoke detector and carbon monoxide detector, Fire Extinguisher (2A10BC) are in operable condition. Per Licensee no one smokes in the home. Electrical outlets are inaccessible, no baby bouncers saucer chairs, or any recalled and or prohibited toys or sleep/ play equipment were observed on the premises. There is a designated area for ill children as necessary in main care area. LPAs observed weapon/firearms to be inaccessible to children in care (off limits). The facility sketch is complete and current, there is working telephone (landline and cell).
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE: DATE: 11/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/22/2022
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: DIAZ FAMILY CHILD CARE
FACILITY NUMBER: 197415024
VISIT DATE: 11/22/2022
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Fire/earthquake drills are complete and maintained current. Last fire/disaster drill was completed on 09/04/22.

Roster complete and maintained current.

Bathroom: Shower/tub are free of hazards (child care bathroom located in the converted garage). LPAs did not observe any hazardous items in the children's bathroom. Toilet and faucet are clean and operable.

Kitchen: Sharp utensils, open bottles or alcohol are inaccessible. If food is brought from the children’s home, the container shall be labeled with the child’s name and properly stored or refrigerated. The home has a clean and fully stocked refrigerator/freezer. Cleaning supplies are in the upper cabinet (off limit with magnet lock). cleaning supplies in the garage with key lock made inaccessible to children in care. Breakfast, lunch, and snacks are provided. Naps are provided on mats in the main care area.

Outdoor: The backyard is safe for children. The backyard is completely fenced (with block cement). LPA observed age appropriate toys and playground with wooden chips. Per licensee, there are no pets on the premises. There is a outdoor storage shed made inaccessible to children with master lock. LPAs also observed another storage shed with toys for outdoor play. The rest of the backyard is off limits with barricaded gate and key lock.

LPAs observed a swimming pool in the off limit area in the backyard. The pool is barricaded by a fence and locked with a master key lock following Title 22 regulations.

Advisory/Other: First Aid kit was observed with supplies readily available. CPR/First Aid expires 10/01/2023. Mandated Reporter expired 10/03/2022. Licensee will retake the mandated reporter training and send a copy to LPA Tamayo for proof of completion. There are no window cords accessible to children.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:

DATE: 11/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2022
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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: DIAZ FAMILY CHILD CARE
FACILITY NUMBER: 197415024
VISIT DATE: 11/22/2022
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Documents Provided and or Discussed: Fire Drill Log, Roster, Postings, Safe Sleep PIN 20-24-CCP, Individual Sleeping Plan (LIC9227) and Emergency Disaster Plan. Licensee stated currently has child care insurance.

Licensee Diaz 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.

LPAs discussed the safe sleep regulations with licensee Diaz 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. LPAs 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.

A notice of site visit was given to licensee and must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the licensee Ericka Diaz along with her appeal rights.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:

DATE: 11/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2022
LIC809 (FAS) - (06/04)
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