334830676-2-22-2023-09-CC-JGIE-CPAPVK-20230222103917

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 334830676
Report Date: 02/22/2023
Date Signed: 02/22/2023 10:39:25 AM

Document Has Been Signed on 02/22/2023 10:39 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME:	DIAZ FAMILY CHILD CARE		FACILITY NUMBER:	334830676
ADMINISTRATOR:	DIAZ, LORENA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(951) 785-8978
CITY:	RIVERSIDE	STATE: CA	ZIP CODE:	92505
CAPACITY:	14	CENSUS: 0	DATE:	02/22/2023
TYPE OF VISIT:	Case Management - Health Checks	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Lorena Diaz		TIME COMPLETED:	10:45 AM

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	On date and time listed, Licensing Program Analyst (LPA) arrived at the facility to conduct a Case Management Health Check of the facility. Present during this inspection was Licensee, Lorena Diaz. LPA did not observe any children in care, Licensee stated they will pick up school age children later in the afternoon. LPA toured the facility, inside and out and the following was observed and/or discussed: Normal days and hours of operation are: Monday - Friday 6:00am to 6pm OFF-LIMIT AREAS INCLUDE: Three of four bedrooms, office, and backyard (where the pool is located) · The facility is operating within the licensed capacity and appropriate ratios: no children present · The Licensee is present in the home · When temporarily absent from the home, the Licensee shall arrange for a substitute adult to care for and supervise children · A working telephone is present · Appropriate fire extinguisher, smoke detector and carbon monoxide detector are present and were tested by the Licensee during this inspection · All hazardous items are inaccessible, this includes detergents, cleaning compounds, medications and other items which could pose a danger to children · Storage of poisons is inaccessible to children and locked in laundry room. · No guns or weapons present as stated by the Licensee. Licensee understands all guns, weapons and ammunition must be key-locked separately and made inaccessible per Title 22 regulations.

SUPERVISOR'S NAME: Gilbert Sena	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Justin Giese	TELEPHONE: (951) 204-4847
LICENSING EVALUATOR SIGNATURE:	DATE: 02/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/22/2023

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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: DIAZ FAMILY CHILD CARE	FACILITY NUMBER: 334830676
	VISIT DATE: 02/22/2023

NARRATIVE

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· Single story home, no stairs
· Home is clean and orderly, with heating and ventilation for safety and comfort
· Safe and appropriate toys and equipment are present for both indoor and outdoor activities.
· Outdoor play areas are fenced
· Verification of control of property on file
· Facility Sketch, Emergency Disaster Plan & Notification of Parent’s Rights poster are posted
· Pediatric CPR and First Aid Card - expire 04/24/2023
· Health & Safety Certificate - completed on file
· There is an in-ground pool located in the back yard. The pool is gated with a five foot mesh fence, which has a self latching/closing door. The pool is gated in compliance with Title 22 regulations, at this time.

Documentation of last fire drill was conducted: 01/04/2023

Criminal record clearances are required prior to all adults living or working in a Family Child Care Home. A civil penalty of $100.00 per day the person has been present, may be assessed. All individuals subject to a criminal record review shall obtain a criminal record clearance or exemption prior to working, residing or volunteering in a licensed home. This was verified on 02/22/2023

Reminders:

- Current facility’s phone numbers must be on file at all times.
- Failure to meet the posting requirements shall result in an immediate $100 civil penalty.
- Documentation of fire & earthquake drills are to be conducted every six months
- Responsibilities of being a mandated reporter
- Baby walkers, bouncy seats, exersaucers and other similar items are prohibited

SUPERVISOR'S NAME: Gilbert Sena	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Justin Giese	TELEPHONE: (951) 204-4847
LICENSING EVALUATOR SIGNATURE:	DATE: 02/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/22/2023

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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: DIAZ FAMILY CHILD CARE	FACILITY NUMBER: 334830676
	VISIT DATE: 02/22/2023

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- Once issued, the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. If a serious violation is cited, a copy of the licensing report (LIC809/LIC9099) must also be posted for 30 days. A civil penalty of $100 per violation will be assessed for noncompliance.

- Access to forms & Regulations for Family Child Care Homes online at www.ccld.ca.gov.
- Responsibility to know the regulations for anyone providing care
- Inaccessibility of hazards must be constantly reassessed depending on the children in care

- Please subscribe to childcareadvocatesprogram@dss.ca.gov to receive Department updates. They will be sent directly to your e-mail account once you have set up an account. This website can also be accessed through www.ccld.ca.gov

The Duty Officer is available to answer questions Monday – Friday at 951-782-4200

Centralized Complaint Intake Bureau is available at: 1-844-LET-US-NO (1-844-538-8766).

The Licensee was informed of their reporting requirements and is provided with the Regional Office’s Unusual Incident Reporting email mailbox: UnusualIncidentReportsDO09@dss.ca.gov

Exit interview conducted and report was reviewed with the licensee, Lorena Diaz.

A notice of site visit was given:

THE LICENSEE UNDERSTANDS THAT IT MUST REMAIN POSTED FOR THE NEXT 30 DAYS

SUPERVISOR'S NAME: Gilbert Sena	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Justin Giese	TELEPHONE: (951) 204-4847
LICENSING EVALUATOR SIGNATURE:	DATE: 02/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/22/2023

LIC809 (FAS) - (06/04)

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