198009860-3-28-2024-33-CC-MSIA-D3STT9-20240328150021

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198009860
Report Date: 03/28/2024
Date Signed: 03/28/2024 03:00:28 PM

Document Has Been Signed on 03/28/2024 03:00 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	DIAZ FAMILY CHILD CARE		FACILITY NUMBER:	198009860
ADMINISTRATOR:	LAURA DIAZ		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(626) 815-5925
CITY:	AZUSA	STATE: CA	ZIP CODE:	91702
CAPACITY:	14	CENSUS: 9	DATE:	03/28/2024
TYPE OF VISIT:	Annual/Required	UNANNOUNCED	TIME BEGAN:	01:05 PM
MET WITH:	Licensee Laura Diaz		TIME COMPLETED:	04:00 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	Visit Conducted in Spanish Licensing Program Analyst (LPA) Mary Silva conducted an unannounced annual required inspection at the above facility on 03/28/24 at 1:05pm. Licensing staff met with Licensee Laura Diaz, whom the reason for the visit was explained. LPA was guided analyst on a tour of the facility. There were nine children present two of which were infants. Facility capacity is in compliance for a Large Family Child Care Home. Per licensee eleven children are currently enrolled. Hours of operation are Monday-Friday 6:00 AM - 6:00 PM. This is a one story home which consists of 2 bedrooms, 1 ½ bathrooms, kitchen, dining room, large living room(daycare room), attached garage, fenced front and backyard. Currently residing in the home are three adults and no minor children. There was a total of 2 adults present during this inspection. Licensee and assistant Alexandra Diaz(daughter). Areas accessible to children were inspected as follows: kitchen, dining room, large living room(daycare room) one bedroom, one bathroom, both are located in the hallway and fenced back yard. Areas off limits include: One bedroom, ½ bathroom, front yard and attached garage. LPA observed the following required posted documentation in the main entry way of the facility: Facility License, Publication (PUB) 394- Notification of Parent Rights and Licensing Form (LIC) 9148- Earthquake Preparedness form. LPA reviewed facility records for LIC 9040- Facility Roster, LIC 610- Facility Disaster Plan. LPA observed disaster drill conducted on 03/12/2024. The home was observed to be clean and orderly, with central air and heating. Licensing staff observed a wall heater located in the hallway covered by a metal barricade. _____________________________Page 1__________________________________________

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Mary Silva	TELEPHONE: (323) 558-2711
LICENSING EVALUATOR SIGNATURE:	DATE: 03/28/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2024

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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: DIAZ FAMILY CHILD CARE	FACILITY NUMBER: 198009860
	VISIT DATE: 03/28/2024

NARRATIVE

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Licensing staff observed the smoke detector and the carbon monoxide detector to be in operable condition. Licensing staff observed the valve on the required 2A 10BC fire extinguisher indicates fully charged with receipt dated 09/03/2023. Reminded licensee fire extinguisher should be serviced yearly. The home maintains telephone service via land line and cell phone. There are toys and other age-appropriate material available for children. Licensee prepares breakfast, lunch, and snack for the children in care. Licensee transports children afterschool.

Licensee states that there are no poisons stored in the home and understands that all poisons must be locked, to be made inaccessible to children. Per Licensee there are no firearms or weapons stored in the home. Licensing staff reminded licensee smoking is not allowed in the home.

The Licensee uses the back yard for outdoor play. The outdoor play areas were observed to be fenced. Licensing staff observed that the outdoor yards have toys and other materials for children to play with.

Child’s records were reviewed for (LIC) 282- Affidavit Regarding Liability Insurance, Immunization's Records, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, and LIC 995A Notification of Parents’ Rights.

Licensee file was reviewed for the following: LIC 508- Criminal Record Statement, Proof of immunizations against measles, pertussis and influenza or influenza declination, TB clearance or risk assessment, LIC 9108- Statement Acknowledging Requirement to Report Child Abuse. Pediatric First Aid and CPR certification on expires 10/10/2025 for licensee, and for assistant Alexandra Diaz. Mandated Reporter Training has been completed and expires on 06/09/2024 for licensee and for Alexandra Diaz. www.mandatedreporterca.com

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. Licensee currently has two infants enrolled. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

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SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Mary Silva	TELEPHONE: (323) 558-2711
LICENSING EVALUATOR SIGNATURE:	DATE: 03/28/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2024

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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: DIAZ FAMILY CHILD CARE	FACILITY NUMBER: 198009860
	VISIT DATE: 03/28/2024

NARRATIVE

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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. 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: https://www.ada.gov/resources/child-care-centers/.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

MyChildCarePlan.org – Centers and Family Child Care Homes - Licensee, was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

Megan’s Law - Family Child Care Homes - During the exit interview, Licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

Based on Licensing staff observations and records review, no deficiencies listed are being cited in accordance with California Code of Regulations Title 22.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. Appeal rights was given.

Exit interview was conducted and report was reviewed with licensee Laura Diaz

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SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Mary Silva	TELEPHONE: (323) 558-2711
LICENSING EVALUATOR SIGNATURE:	DATE: 03/28/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2024

LIC809 (FAS) - (06/04)

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