115407245-8-8-2019-13-CC-DWIN-BEUMQM-20190808094859

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 115407245
Report Date: 08/08/2019
Date Signed: 08/08/2019 09:49:20 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME:	DIAZ, ROSA FAMILY CHILD CARE HOME		FACILITY NUMBER:	115407245
ADMINISTRATOR:	DIAZ, ROSA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(530) 988-9212
CITY:	ORLAND	STATE: CA	ZIP CODE:	95963
CAPACITY:	14	CENSUS: 0	DATE:	08/08/2019
TYPE OF VISIT:	Office	ANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Rosa Diaz		TIME COMPLETED:	10:00 AM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	An informal office meeting was conducted on 08/08/2019 at 9:00am with licensee Rosa Diaz, Licensing Program Manager Erin Virrueta and Licensing Program Analyst David Wilson at the Chico Regional Office to discuss a violation of Health and Safety Code (H&SC) 1597.58(C)(2). This H&SC is for Absence of supervision, including, but not limited to, a child left unattended and a child left alone with a person under 18 years of age. This requirement was not met as evidenced by: interviews, record reviews and observation the licensee failed to supervised when children left facility property unsupervised. On 07/08/2019 a Plan of Correction for the above violation was cleared. On 06/27/19 licensee provided pictures of adequate safety door knobs, latches and door/window alarms to ensure children cannot readily open doors to leave the facility unsupervised (LPA observed the safety measures at facility on 07/02/19). On 07/08/19 licensee provided written understanding of Title 22 section 102417. On 07/08/19 licensee provided a weekly child day care schedule. This said schedule listed days, hours, children and supervisors as a weekly written planned schedule in general of the day care operation. A $500 civil penalty was assessed for the absence of supervision.

SUPERVISOR'S NAME: Erin Virrueta	TELEPHONE: (530) 895-4325
LICENSING EVALUATOR NAME: David Wilson	TELEPHONE: (530) 513-0993
LICENSING EVALUATOR SIGNATURE:	DATE: 08/08/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2019

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, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: DIAZ, ROSA FAMILY CHILD CARE HOME	FACILITY NUMBER: 115407245
	VISIT DATE: 08/08/2019

NARRATIVE

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Action items:
1) Licensee will ensure to always provide fingerprint cleared and associated to the facility adults to supervise children.
2) Licensee will ensure to always provide adequate Care and Supervision in compliance with Title 22 Regulation Section number 102417 Operation of a Family Child Care Home, and has a plan in place for an assistant provider to be present when necessary.
3) Safety measures must remain in place in the facility to prevent children from leaving the facility unsupervised by a cleared and associated adult. These measures include safety door knobs, window/door alarms and latches to ensure children cannot readily open windows/doors to leave the facility unsupervised.
4) Licensee to provide a monthly schedule at the end of the month of day care operations denoting, times, names/date of births of children and the name of the supervisor for children on noted dates and times.
5) Licensee stated she will re-do her floor plan to limit areas where day care children's access can be controlled by licensee.

Compliance monitoring will be conducted bi-annually.

This report was read and reviewed with licensee Rosa Diaz. Ms. Diaz signature below denotes licensee's understanding of this report including action items as listed above.

SUPERVISOR'S NAME: Erin Virrueta	TELEPHONE: (530) 895-4325
LICENSING EVALUATOR NAME: David Wilson	TELEPHONE: (530) 513-0993
LICENSING EVALUATOR SIGNATURE:	DATE: 08/08/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2019

LIC809 (FAS) - (06/04)

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