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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020076
Report Date: 02/04/2020
Date Signed: 02/04/2020 09:27:16 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:
198020076
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 3DATE:
02/04/2020
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Marianela DiazTIME COMPLETED:
09:40 AM
NARRATIVE
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Licensing Program Analyst (LPA) Ariel Cazares conducted a plan of correction inspection on this date. The purpose of this inspection was to follow up on cited deficiencies and ensure these deficiencies were corrected in a timely manner. Upon arrival LPA met with Licensee Marianela Diaz and observed 3 children.

A visit was conducted on 1/28/2020. The facility was cited for the following:

102417(g)(5)- LPA observed a fish pond/water fountain in the backyard that was not fenced and inaccessible.
On this date, LPA inspected and measured the installed fence. LPA informed licensee that the fence was short of 5 feet and would need to add on. LPA measured the gaps in between an found that they measured more than 4 inches. LPA advised licensee of what the measurements needed to be and how short they were from meeting regulations. Although the fencing does not meet the required measurements, there is no immediate risk. LPA observed the fence is secure and stable, but will need to comply with required measurements.

102417(g)(1)- LPA observed the fire extinguisher was not serviced in the year since it was purchased.
Corrected: Fire extinguisher in the home was observed to be fully charged and purchased on 1/29/2020.

The licensee was advised that corrections were required for the fencing surrounding the fish pond/water fountain. See 809-D for deficiency cited. An exit interview was conducted with Licensee Marianela Diaz. A copy of this report and appeal rights were distributed and explained. The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site inspection by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.
SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Ariel CazaresTELEPHONE: (323) 981-2949
LICENSING EVALUATOR SIGNATURE:

DATE: 02/04/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2020
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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: DIAZ FAMILY CHILD CARE
FACILITY NUMBER: 198020076
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/04/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/05/2020
Section Cited

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Fences shall be at least five feet high and shall be constructed so that the fence does not obscure the pool from view. The bottom and sides of the fence shall comply with Division 1, Appendix Chapter 4 of the 1994 Uniform Building Code. In addition to meeting all of the gates shall swing away from the pool, self-close and and have a self-latching
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device located no more than six inches from the top of the gate. Pool covers shall be strong enough to completely support the weight of an adult and shall be placed on the pool and locked while the pool is not in use.
This requirement has not been met as evidenced by LPAs measurement of the fence. Fence did not meet required...
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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: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Ariel CazaresTELEPHONE: (323) 981-2949
LICENSING EVALUATOR SIGNATURE:
DATE: 02/04/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/04/2020
LIC809 (FAS) - (06/04)
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