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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 214005515
Report Date: 08/04/2020
Date Signed: 08/04/2020 11:51:50 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:CATZIM DIAZ, REINA G.FACILITY NUMBER:
214005515
ADMINISTRATOR:CATZIM DIAZ, REINA G.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 524-9434
CITY:NOVATOSTATE: CAZIP CODE:
94947
CAPACITY:14CENSUS: 5DATE:
08/04/2020
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Licensee, Reina Catzim DiazTIME COMPLETED:
11:10 AM
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THE FOLLOWING INSPECTION WAS CONDUCTED VIA TELE-INSPECTION DUE TO THE COVID-19 HEALTH EMERGENCY.

On 8/4/2020 at 10:45A.M., Licensing Program Analyst (LPA), Luis J. Gomez met with licensee, Reina Catzim Diaz. Purpose of the inspection was explained and is for a scheduled Case Management inspection to add the Garage Area and Bedroom #1 (Napping only) into the day-care. Present is the licensee and her daughter (Minor) caring for five children; Three preschool age and two infant age. Licensee stated one of the infants is her daughter. All adults in the home have criminal record clearances on file. LPA inspected the facility with licensee for health and safety hazards.

At 10:50A.M., LPA inspected the garage area. Garage area is clean, orderly with plenty of age appropriate books, crafts and toys for the children. There are several child size tables, chairs available for snack and activities. All inspected items are in proper repair. Licensee installed a large child safety gate, making the washer and dryer area inaccessible.

At 10:58A.M, LPA inspected bedroom #1. Licensee stated bedroom #1 will be used primarily for napping only. LPA observed child safety handles on the closet door. All outlets and trash cans in bedroom #1 are inaccessible. Infant items and playthings located in bedroom #1 are in good repair.

LPA reminded licensee that garage area should be used as a playroom only.

Prior to area(s) becoming incorporated, Licensee must complete the following:

-Remove or making all medication on counter in bedroom #1 inaccessible.

-Remove or make all toxins and detergents in the garage area inaccessible.

This report must be available in the facility for public review. Notice of site visit was observed being posted. Licensee was advised any additional questions to call Office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.cdss.ca.gov

SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis GomezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 08/04/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2020
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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