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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197700392
Report Date: 06/09/2021
Date Signed: 06/09/2021 04:11:19 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:DIAZ-BANOS FAMILY CHILD CAREFACILITY NUMBER:
197700392
ADMINISTRATOR:BLANCA DIAZ-BANOSFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 418-6088
CITY:LANCASTERSTATE: CAZIP CODE:
93534
CAPACITY:14CENSUS: 9DATE:
06/09/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:25 PM
MET WITH:Blanca Diaz-BanosTIME COMPLETED:
04:15 PM
NARRATIVE
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On June 9, 2021 at 2:25PM, Licensing Program Analyst (LPA) Brigitte Tsutaoka conducted an unannounced annual random inspection. The LPA disclosed the purpose of the inspection and was granted entry by Licensee's Assistant Fatima Borda. Licensee Blanca Diaz-Banos arrived at facility at 2:35PM and guided LPA on a tour of the facility. Upon entry to the facility, LPA observed 9 children in care.

This is a two story home with 4 bedrooms, 3 bathrooms, kitchen, living room, dining room, family room, and garage. There is no pool/spa or body of water on the premises. Main care is provided in the family room and living room. Children use the restroom next to the kitchen. Stairs have a gate. The fireplace in the living room is securely inaccessible to children.

The day care home provides breakfast, lunch, and afternoon snack, as needed. According to Licensee the operating childcare hours are Monday through Saturday from 6:00AM - 6:00PM.



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. The knives are in a top kitchen cabinet. Medications are kept in the kitchen inaccessible to children. All cleaning supplies and detergents are stored in the kitchen locked under the sink. Per Licensee, there are no weapons or firearms of any kind in the facility. LPA did not observe any during inspection.
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Brigitte TsutaokaTELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:

DATE: 06/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2021
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 4
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: DIAZ-BANOS FAMILY CHILD CARE
FACILITY NUMBER: 197700392
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/09/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/16/2021
Section Cited

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102419 Admission Procedures and Parental and Authorized Representatives Rights: At the time of acceptance of each child into care, the licensee shall provide the child's parent or authorized representative with a copy of the notice Family Child Care Home Notification of Parents’ Rights, LIC 995A . This requirement was not met as evidence by:
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Based on observation and record review: Child files did not contain a signed copy of the Notification of Parents' Rights (LIC 995A).
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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.
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Brigitte TsutaokaTELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:
DATE: 06/09/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/09/2021
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: DIAZ-BANOS FAMILY CHILD CARE
FACILITY NUMBER: 197700392
VISIT DATE: 06/09/2021
NARRATIVE
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There are age appropriate toys and equipment on the premises.

The First Aid kit was observed and complete. The required fire extinguisher (2A10BC) meets State Fire Marshall standards. The smoke and carbon monoxide detector are in operable condition (tested at 3:00PM). Fire and disaster drills are conducted every three-months, last emergency drill was conducted on March 31, 2021. Licensee's Pediatric CPR and First Aid certificate expires on 11/23/2021.

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



LPA observed a current child roster. Child files were missing Parents Rights (LIC995A). LPA provided a copy to Licensee during inspection.

The backyard has a designated play area that 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 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 analyst of any person who will be visiting regularly or for longer than #1 week.
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Brigitte TsutaokaTELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:

DATE: 06/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2021
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: DIAZ-BANOS FAMILY CHILD CARE
FACILITY NUMBER: 197700392
VISIT DATE: 06/09/2021
NARRATIVE
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Safe Sleep regulations were discussed with Licensee and referred to the CCL web site for additional information and PINS.

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. Licensee provided Mandated Reporter Training certificate which will expire 3/20/2022.

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 cited a Type B violation during inspection. Please see LIC809D for deficiency details.

An exit Interview was conducted, a copy of this Report, Appeal rights and a Notice of Site visit was provided to the licensee Blanca Diaz-Banos .

SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Brigitte TsutaokaTELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:

DATE: 06/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2021
LIC809 (FAS) - (06/04)
Page: 4 of 4