197418839-10-25-2019-12-CC-IORA-BHAR2H-20191025123823

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197418839
Report Date: 10/25/2019
Date Signed: 10/25/2019 12:43:31 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 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: 9	DATE:	10/25/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:29 AM
MET WITH:	Edith Dieguez		TIME COMPLETED:	12:39 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	Licensing Program Analyst (LPA) Isabel Ortega conducted an unannounced annual random inspection. The LPA met with licensees Edith Dieguez and Elsie Dieguez who guided the LPA at 8:40 A.M. on a tour of the facility. Also present today are two adults which are fingerprint cleared. Upon entry to the facility the LPA observed a total of 9 children under care, 3 infants and 6 school age children. This is a single-story family home. There is a living room, kitchen, dining room, three bedrooms, one restroom and a detached garage. Main care is provided in the living room which is referred to the playroom. The children use the bathroom located next the kitchen to the left. The living room is barricaded by a half door to prevent children from accessing the rest of the home(Licensee was reminded to make sure door is maintained closed). The off-limits areas are all the three bedrooms(high chain lock observed), kitchen(child proof gate observed and reminder given to keep gate close during child care operation hours), laundry room and side storage room next to the dinning room(maintained locked). The day care home provides breakfast, morning snack, lunch, afternoon snack, and dinner as needed. According to Licensee she is currently participating in a food nutrition program (Ventura Food Program). The facility transports children. The licensee driver’s license expires on 05/30/2021. The licensee has valid vehicle insurance which expires on 03/02/20. The operating child care hours are Monday through Friday from 6:00 A.M. to 6:30 P.M.

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Isabel Ortega	TELEPHONE: (661) 789-6944
LICENSING EVALUATOR SIGNATURE:	DATE: 10/25/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2019

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, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME: DIEGUEZ FAMILY CHILD CARE	FACILITY NUMBER: 197418839
	VISIT DATE: 10/25/2019

NARRATIVE

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The home was inspected inside and out for safety, comfort, cleanliness, telephone service, and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children. The knives are kept in the kitchen on the top cabinet. All cleaning chemicals are stored in the laundry room and maintained locked. Medication is stored in an off limits master bedroom inaccessible to children.

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 LPA did not observe any weapons.

The First Aid kit was observed and complete. The required fire extinguisher (2A10BC) is in green, smoke and carbon monoxide detector is in operable condition (tested 9:15 A.M.). Fire and disaster drills are conducted monthly, last emergency drill was conducted 10/16/2019 at 4:30 P.M. Licensee's Pediatric CPR and First Aid certificate expires on 03/2021.

The facility annual fees are current. 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)

Licensees (both)was able to provide proof of immunization against pertussis (TDAP), measles (MMR), TB and Influenza.

Licensee also provided Mandated Reporter certification of completion dated 10/22/2018 for both licensees Edith and Elsie Dieguez.

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

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Isabel Ortega	TELEPHONE: (661) 789-6944
LICENSING EVALUATOR SIGNATURE:	DATE: 10/25/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2019

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, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME: DIEGUEZ FAMILY CHILD CARE	FACILITY NUMBER: 197418839
	VISIT DATE: 10/25/2019

NARRATIVE

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The backyard has two sections with a gate dividing the enclosed pool a latching gate was observed. According to licensee children do not use the pool nor go to the backyard. The back yard has been placed off limits effective today(Licensee completed a declaration). The front yard is barricaded all around and there is a gate operated by an inside buzzer for entry security. The outdoor front play area was inspected and was observed to not 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 LPA also discussed earthquake safety and necessity of drills, required forms for children’s files, facility files and posting requirements and penalty.

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 one week.

The applicant was advised of the requirement to report Unusual Incidents. A report shall be made to the department by telephone or fax during the department's normal business hours before the close of the next working day following the occurrence during the operation of family day care home. In addition, a written report shall be submitted to the department within seven days following the occurrence of any events specified above. The applicant was informed to utilize the Unusual Incident Report/Injury Report form LIC624B when submitting the report to the department.

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Isabel Ortega	TELEPHONE: (661) 789-6944
LICENSING EVALUATOR SIGNATURE:	DATE: 10/25/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2019

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, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME: DIEGUEZ FAMILY CHILD CARE	FACILITY NUMBER: 197418839
	VISIT DATE: 10/25/2019

NARRATIVE

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Safe Sleep new upcoming Proposed Regulations were discussed with Licensee and referred to the CCL web site (www.ccld.ca.gov) for additional information on safe sleep, recent recalls and PINS.

Went over new immunization record keeping effective 7/01/2019. New Regulation regarding 15-month infants’ vaccinations for chicken pox.

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.

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.

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Isabel Ortega	TELEPHONE: (661) 789-6944
LICENSING EVALUATOR SIGNATURE:	DATE: 10/25/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2019

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, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME: DIEGUEZ FAMILY CHILD CARE	FACILITY NUMBER: 197418839
	VISIT DATE: 10/25/2019

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Licensee was informed the On-Duty-Officer is available for questions Monday through Friday at (661) 789-6944 from 8:00 AM - 5:00 PM.

LPA provided consultation during annual inspection. Local Resource and Referral agency was provided (www.ccrcca.org).

The facility was in compliance per Title 22 regulations, and no deficiencies will be cited today 10/25/2019. An exit Interview was conducted, a copy of this Report and a Notice of Site visit was provided to the licensee. Appeal rights were provided and discussed with licensee Edith Dieguez.

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Isabel Ortega	TELEPHONE: (661) 789-6944
LICENSING EVALUATOR SIGNATURE:	DATE: 10/25/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2019

LIC809 (FAS) - (06/04)

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