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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197408673
Report Date: 02/13/2025
Date Signed: 02/13/2025 07:59:59 PM

Document Has Been Signed on 02/13/2025 07:59 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
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:DIAZ MARTINEZ FAMILY CHILD CAREFACILITY NUMBER:
197408673
ADMINISTRATOR/
DIRECTOR:		SANDRA DIAZ MARTINEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 782-2803
CITY:TORRANCESTATE: CAZIP CODE:
90501
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: DATE:
02/13/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:56 PM
MET WITH:Sandra Diaz Martinez - LicenseeTIME VISIT/
INSPECTION COMPLETED:
02:35 PM
NARRATIVE
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On 02/13/2025 Licensing Program Analyst (LPA) Cristina Castellanos conducted an unannounced Case Management Inspection at the above-mentioned facility for the purpose of ensuring the standards are being met in accordance with California Tittle 22 Regulations and California Health and Safety Codes. Upon Arrival LPA was greeted by Licensee Diaz Martinez. LPA Castellanos introduced herself, disclosed the purpose of the inspection and was granted entry into the home. Present during today’s inspection were Licensee S. Diaz Martinez, licensee’s minor child and two (2) adult staff members.

Based on LPA observation, interviews, and record review, all three (3) personnel files were incomplete. Proof of Pediatric CPR/Pediatric First Aid were not available for LPA review.

LPA reviewed with applicant the LIC 311D, Forms/Records to Keep in Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. Additionally, LPA provided Licensee Diaz Martinez the Entrance Checklist and the CAL FIRE - Office of the State Fire Marshal Information Bulletin 20-008 Issued: March 19, 2021.



There was one (1) deficiency Type B cited during today’s inspection in accordance with the California Code of Regulations, Title 22, Division 12, and Chapter 3. See LIC 9099-D for additional information. As well as Technical Violations were issued.

An exit interview was conducted, and report was reviewed with Licensee Diaz Martinez. A copy of this report and appeal rights were discussed and left with Licensee Diaz Martinez, whose signature on this form confirm receipt of these documents. Upon receipt of this report, the Licensee shall post the Notice of Site Visit. The Notice of Site Visit shall be posted for 30 consecutive days. Failure to maintain posting as required, will result in an immediate $100 civil penalty.
Claudia EscobedoTELEPHONE: (424) 301-3044
Cristina CastellanosTELEPHONE: 424-301-3097
DATE: 02/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/13/2025
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 02/13/2025 07:59 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245


FACILITY NAME: DIAZ MARTINEZ FAMILY CHILD CARE
FACILITY NUMBER: 197408673

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/13/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/17/2025
Section Cited
CCR
102416(c)

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(c) The licensee and other personnel as specified shall complete training on ... pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866.
This requirement is not met as evidenced by:
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Licensee agrees to have all staff members personnel files completed. Licensee will submit proof of enrollment/receipt or First Aid/CPR certification to LPA via email by POC due date.
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Based on observation, interview and record review, the licensee did not comply with the section cited above: Licensee was unable to provide LPA proof of a current First Aid/CPR, which poses/posed a 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.
Claudia EscobedoTELEPHONE: (424) 301-3044
Cristina CastellanosTELEPHONE: 424-301-3097

DATE: 02/13/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/13/2025

LIC809 (FAS) - (06/04)
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