<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197418839
Report Date: 07/18/2019
Date Signed: 07/18/2019 02:11:08 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550
FACILITY NAME:DIEGUEZ FAMILY CHILD CAREFACILITY NUMBER:
197418839
ADMINISTRATOR:DIEGUEZ, EDITH & ELSIEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 481-6858
CITY:PACOIMASTATE: CAZIP CODE:
91331
CAPACITY:14CENSUS: 12DATE:
07/18/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:EDITH DIEGUEZTIME COMPLETED:
10:36 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
Licensing Program Analyst (LPA) Isabel Ortega, conducted an unannounced case management incident inspection. Upon arrival the LPA was greeted by the Licensee Edith Dieguez who guided the LPA on a tour of the Family Child Care Home facility. The purpose of the inspection is in regards to an incident that was reported to the department on 06/11/19.

Description of the incident: Child #1 and Parent #1, were terminated from child care and parent #1 disagreed with termination.

Interviews were conducted with parents and staff. Child #1 was not present on this day. It was determined Parent was notified and options were given for alternative Child Care. Child #1 no longer attends the day care.

Based on information provided and interviews conducted the incident does not appear to have been the result of any violation of the Title 22 regulation, therefore no deficiencies were cited.

During inspection unusual incident/injury report was provided.

An exit interview was conducted and a copy of this report was read and provided to the Licensee, Edith and Elsie Dieguez on this date.
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Isabel OrtegaTELEPHONE: (661) 789-6944
LICENSING EVALUATOR SIGNATURE:

DATE: 07/18/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 1