198016075-9-26-2019-06-CC-YVIA-BGDLZ8-20190926091130

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198016075
Report Date: 09/25/2019
Date Signed: 09/26/2019 09:11:41 AM

COMPREHENSIVE INSPECTION

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	DIAZ FAMILY CHILD CARE		FACILITY NUMBER:	198016075
ADMINISTRATOR:	DIAZ, FLOR		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(562) 902-6480
CITY:	LA MIRADA	STATE: CA	ZIP CODE:	90638
CAPACITY:	14	CENSUS: 3	DATE:	09/25/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Flor Diaz, Licensee		TIME COMPLETED:	03:30 PM

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Licensing Program Analyst (LPA) Villa conducted an unannounced annual random inspection to ensure the health & safety standards as required by regulations governing family child care homes are met. Upon arrival LPA Villa was greeted by Licensee Flor Diaz. Also present during this inspection were Jorge Diaz Tejada and Sergio Diaz, licensees spouse and son. All adults present during this inspection have obtained a criminal record clearance prior to working or residing in the home.

Census was obtained during today’s inspection there was 1 infants and two toddler present during the inspection. The facility was observed to be within capacity. This is a large family child care home licensed for 14 children.

Licensee states her hours of operation are from 5:00 am-6:00pm. Licensee states there are 11 children enrolled in the day care. An updated children roster was available during this inspection. A tour of the home was conducted inside and outdoors. Per Licensee there are 3 adult residing in the home. This is a 3 bedroom and bathroom residence. The children use the playroom located towards the back of the home and the restroom located in the hallway. The off-limit areas are the three bedrooms located in the hallway and other restroom located inside the master bedroom. LPA Villa observed all of the off-limit areas locked during this inspection. The children use the backyard patio of the home for outdoor play time. There are no bodies of water located on the property. The backyard was observed to be fenced with age appropriate toys and free of hazards.

Licensee has the Parent’s Rights poster and other appropriate forms posted. Pediatric First Aid/CPR certificates are valid thru 03/16/2021 for licensee. Staff files were reviewed for Immunizations, MMR, TDAP and Influenza and Mandated Reporter certificate for Licensee and assistant. All files were not observed to be complete, licensee did not have proof of immunizations for herself and her assistant. Children records were reviewed for LIC700 and Immunization cards. All records were observed to be complete. Licensee was reminded that the Mandated reporter training expires every two years. She is exempt as Spanish is her primary language. Licensee had the fire disaster drill log up to date. Licensee has a working telephone via cell phone and home phone.

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Yesenia Villa	TELEPHONE: (714) 293-9465
LICENSING EVALUATOR SIGNATURE:	DATE: 09/25/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2019

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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: DIAZ FAMILY CHILD CARE	FACILITY NUMBER: 198016075
	VISIT DATE: 09/25/2019

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Detergents and cleaning supplies were inaccessible to the children in care. Fire extinguisher was inspected and met state regulations. There is an operational smoke detector and carbon monoxide in the facility. The licensee maintains a first aid kit in the home. There are adequate age appropriate toys, books, and games. There are no firearms present on the premises as stated by licensee.

The following were discussed: Individuals who are 18 years of age or older living in the home must be finger print cleared prior to being in the presence of the children in care. Individuals within one month of their 18th birthday must be fingerprinted immediately. No smoking, No infant walkers, No baby bouncers, No Johnny jumpers, No exersaucers and any other item that falls into that category is to be in the home. LPA discussed disaster drills, posting requirements, children records requirements, mandated child abuse and injury/death reporting. LPAs reviewed SIDs, safe sleeping practices. Infants should sleep mouth up, on their backs, free of clutter surrounding their sleeping space. Safe sleep guidelines flyer was provided during today’s visit.

Incidental Medical Services (IMS) policy was discussed. Licensee states there are no children requiring medication in her care. 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

LPA advised the Licensee to access forms and regulations on line at: www.ccld.ca.gov, Licensee was advised where to access the quarterly updates.

The following citations will be cited on the 809 D page attached.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 consecutive days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00. Exit interview was conducted with Licensee and Appeal rights were provided and explained. Licensee was informed that appeals must be submitted in writing within 15 days of a citation.

An exit interview was completed with licensee Flor Diaz.

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Yesenia Villa	TELEPHONE: (714) 293-9465
LICENSING EVALUATOR SIGNATURE:	DATE: 09/25/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2019

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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: DIAZ FAMILY CHILD CARE	FACILITY NUMBER: 198016075
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/25/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 10/02/2019 Section Cited	1 2 3 4 5 6 7	1596.7995 Immunizations Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.
	8 9 10 11 12 13 14	This requirement was not met as evidence by: Licensee did not have proof of immunizations, MMR, TDAP during todays inspection for herself and her assistant. This poses a potential risk to the health of the children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7
	1 2 3 4 5 6 7

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: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Yesenia Villa	TELEPHONE: (714) 293-9465
LICENSING EVALUATOR SIGNATURE:	DATE: 09/25/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2019

LIC809 (FAS) - (06/04)

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