197418839-2-6-2020-12-CC-IORA-BLK3DX-20200206171016

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197418839
Report Date: 02/06/2020
Date Signed: 02/06/2020 05:10:24 PM

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:	DIEGUEZ FAMILY CHILD CARE		FACILITY NUMBER:	197418839
ADMINISTRATOR:	DIEGUEZ, EDITH & ELSIE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 481-6858
CITY:	PACOIMA	STATE: CA	ZIP CODE:	91331
CAPACITY:	14	CENSUS: 7	DATE:	02/06/2020
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	03:10 PM
MET WITH:	Elsie Dieguez		TIME COMPLETED:	05:15 PM

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	On 2/6/2020 Licensing Program Analyst (LPA) Ortega and LPA Ayala conducted an unannounced annual random required inspection. The LPAs met with licensee Elsie Dieguez who guided the LPAs on a tour of the facility. Licensee Edith Dieguez arrived to facility with 5 school age children. During inspection there was a total of 7 children in care. This is a single-story family home. There is a living room, kitchen, dining room, 3 bedrooms and one restroom. Main care is provided in the family living room and dining room (referred to the day care area). The children use the bathroom located down the hall to the left from the entrance to the home. The off-limits areas are all the three bedrooms, detached garage (maintained locked), the kitchen and the back yard. The day care home provides breakfast, morning snack, lunch, afternoon snack, and dinner as needed. According to Licensee she is currently participating in the Food Nutrition Program. According to Licensee the operating childcare hours are Monday thru Friday from 6:30 am-6:00 pm. The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children. A floor heater was observed by LPA's on the dinning room floor. LPA's provided advisory and Licensee removed floor heater to an off limits area. The knives are in the kitchen on a top cabinet. Medications are kept in the Master bedroom inaccessible to children. All cleaning supplies and detergents are stored in the off-limits garage.

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Isabel Ortega	TELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:	DATE: 02/06/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2020

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: DIEGUEZ FAMILY CHILD CARE	FACILITY NUMBER: 197418839
	VISIT DATE: 02/06/2020

NARRATIVE

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There are age appropriate toys and equipment on the premises. Per the licensee there are no weapons or firearms of any kind in the facility. The LPAs did not observe any weapons.

The First Aid kit was observed and complete. The required fire extinguisher (2A10BC) is in green and receipt of purchase is dated 10/10/2019. The smoke and carbon monoxide detector are in operable condition (tested at 3:30PM). Fire and disaster drills are conducted every six-month, last emergency drill was conducted on Jan. 09, 2020 at 9:30 AM. Licensee's Pediatric CPR and First Aid certificate expires on 03/20/2021.

Licensee had all the required posted documents: Facility License (LIC 203, Notice of Parent's Rights Poster (PUB 394), Emergency Disaster Plan (LIC 610A), and Earthquake Preparedness Checklist (LIC 9148)

The licensee and Assistant provided proof of immunization against pertussis (TDAP), measles (MMR), and influenza.

The LPAs observed a current child roster. Child files were found to be complete.

The front yard is gated all around. The outdoor play area was inspected and was observed to be free of hazards, loose and sharp parts.

The following were discussed: No smoking, infant walkers, Johnny jumpers, exersaucers and any other item that falls into that category are permitted in the facility. The LPAs also discussed earthquake safety and necessity of drills, required forms for children’s files, facility files and posting requirements and penalty. Licensee was advised to verify numbers on disaster log.

The licensee was informed that all adults living in or having access to the home are required to have fingerprint clearances with Department of Justice, FBI and Child Abuse Index prior to having contact with children. If the aforementioned is not adhered to, a Civil Penalty of up to $500, per non-cleared adult will be assessed immediately. Please advise your analysis of any person who will be visiting regularly or for longer than #1 week.
Safe Sleep regulations were discussed with Licensee and referred to the CCL web site for additional information and PINS. LPA's observed unfitted sheets on infant crib, LPA's provided advisory.

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Isabel Ortega	TELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:	DATE: 02/06/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2020

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: DIEGUEZ FAMILY CHILD CARE	FACILITY NUMBER: 197418839
	VISIT DATE: 02/06/2020

NARRATIVE

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Went over immunization regulations and requirements which were effective 7/01/2019. Regulation regarding varicella(chickenpox) vaccination now due at 15 months month instead 18 months.

Beginning on January 1, 2018, Assembly Bill 1207 (2015) requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Applicants must meet requirements as a precondition to licensure. New employees shall have 90 days from date of employment to complete training as required. The training may be conducted at the following website www.mandatedreporterca.com. Both Licensees provided certification of Mandated Reporter Training dated 10/22/2018. Licensee was advised Mandated Reporter Training certificate will expire by 10/22/2020.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at http://www.ada.gov/childqanda.htm

Child Care Advocates:

To sign up for our Quarterly Updates please email the Child Care Advocates at
chilcareadvocatesprogram@dss.ca.gov & (916) 654-1541

The licensee was informed of the responsibility to report suspected Child Abuse by calling the Child Abuse Hot-line at 1-800-540-4000.

The facility was in compliance per Title 22 regulations, no deficiencies will be cited today 2/6/2020. An exit Interview was conducted, a copy of this Report, Appeal rights and a Notice of Site visit was provided to the licensee Elsie Dieguez.

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Isabel Ortega	TELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:	DATE: 02/06/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2020

LIC809 (FAS) - (06/04)

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