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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197415024
Report Date: 05/21/2024
Date Signed: 05/21/2024 11:23:57 AM

Document Has Been Signed on 05/21/2024 11:23 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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:DIAZ FAMILY CHILD CAREFACILITY NUMBER:
197415024
ADMINISTRATOR/
DIRECTOR:		ERICKA DIAZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 718-3081
CITY:QUARTZ HILLSSTATE: CAZIP CODE:
93536
CAPACITY: 14TOTAL ENROLLED CHILDREN: 12CENSUS: 8DATE:
05/21/2024
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:02 AM
MET WITH:Sofia DiazTIME VISIT/
INSPECTION COMPLETED:
12:00 PM
NARRATIVE
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On 5/21/2024, Licensing Program Analyst (LPA) Carol Heath conducted an unannounced case management visit to verify that the licensee remains in substantial compliance with the health and safety standards required by regulations governing the Childcare Center. LPA met with the Licensee’s daughter, Sofia Diaz. At the time of entry, LPA observed 8 ( 2 2-year-old and 6 3-year-old) children in care, with 2 staff members and the Licensee’s daughter providing care and supervision. Facility operational hours are Monday through Friday from 7:00 a.m. to 5:00 p.m.

The licensee, Ericka Diaz, has been out of town since 5/9/2024 but will return this Saturday (5/25/2024).

The purpose of the visit was to conduct interviews with teachers and related parties. LPA reviewed Teacher #1—Teacher #3's personal information and 3 children’s files and received the facility roster.

The facility was not in compliance with Title 22 regulations, and deficiencies were cited during today's visit.

An exit interview was conducted, and the report was reviewed with the Licensee’s daughter, Sofia Diaz.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE: DATE: 05/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/21/2024
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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Document Has Been Signed on 05/21/2024 11:23 AM - It Cannot Be Edited


Created By: Carol Heath On 05/21/2024 at 10:28 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
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: DIAZ FAMILY CHILD CARE
FACILITY NUMBER: 197415024

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/21/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/21/2024
Section Cited
CCR
102417(a)

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The licensee shall be present in the home and shall ensure that children in care are supervised at all times. .. Temporary absences shall not exceed 20 percent of the hours that the facility is providing care per day. This requirement is not meet as evidenced by:
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The licensee's daughter stated she would complete 8 hours of Health and Safety Training today and Email the LPA. The facility will only allow 8 children in a family childcare home. The licensee's daughter signed the declaration to mandate small family child care capacity.
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Based on observation and interview, the licensee, Ericka Diaz went out the town since 5/9/2024 and will return until 5/25/2024. She is absence 20% of her operation hour Which poses an potential Health, Safety, or Personal Rights risk to persons 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:Claretta Yates
LICENSING EVALUATOR NAME:Carol Heath
LICENSING EVALUATOR SIGNATURE:
DATE: 05/21/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/21/2024


LIC809 (FAS) - (06/04)
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