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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198009860
Report Date: 07/26/2019
Date Signed: 07/26/2019 11:41:37 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:DIAZ FAMILY CHILD CAREFACILITY NUMBER:
198009860
ADMINISTRATOR:LAURA DIAZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 815-5925
CITY:AZUSASTATE: CAZIP CODE:
91702
CAPACITY:14CENSUS: 0DATE:
07/26/2019
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Laura Diaz and Cynthia EsquidaTIME COMPLETED:
11:30 PM
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A meeting was held on this date to discuss the facility history and to review the terms in the compliance plan presented to Ms. Laura Diaz, Licensee and Cynthia Esquida, licensee's daughter. Licensing Program Manager, Christina Gabelman and Ana Chico, Licensing Program Analyst, met with Ms. Diaz. to discuss the facility file history and Compliance Plan.

[X] Criminal Record Clearance 102370 (d): 12/23/2008
[X] Personnel Records 102416.1(a)(10): 5/31/2012
[X] Reporting Requirements 102416.2 (b) : 9/18//2012
[X] Employees or volunteers;immunization requirements;records;exemptions H&S1596.7995: 1/30/2018
[X] Mandate Reporter Training H&S1596.8662: 1/23/2019
[X]Employees or volunteers; immunization requirements; records;exemptions H&S1596.7995(a)(1): 5/17/2019

LPA Chico conducted the meeting in Spanish to ensure that Ms. Diaz fully understands what is being discussed and her compliance plan. Licensee was informed to start going onto the Community Care Licensing website at www.ccld.ca.gov to get the Quarterly updates which has good information.

Licensee has agreed to submit the transportation plan by August 1, 2019 as stipulated in the compliance plan as follows: The licensee has agreed to submit a transportation plan, which will include who will be transporting children and proof of qualifications for the person( s) designated to transport children.

LPA Ana Chico clarified with licensee that she understands that her husband cannot have anything to do with the operation of her day care or be present at her day care during operation hours she is conducting business.
The licensee has been advised that the Department will conduct more frequent inspections to the facility in the next three years to ensure compliance. In addition to the above, the licensee states that she will stay in compliance with Title 22 Regulations. A copy of this report shall be provided to the parent/guardian of children currently enrolled . The Acknowledgement form (LIC 9224) must be maintained in each child’s file immediately upon receipt from parent. Exit interview was conducted with Laura Diaz, Licensee. Appeal Rights provided and explained.
SUPERVISOR'S NAME: Katherine HarewoodTELEPHONE: (323) 981-2956
LICENSING EVALUATOR NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR SIGNATURE:

DATE: 07/26/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2019
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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