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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426215812
Report Date: 09/18/2020
Date Signed: 09/23/2020 05:24:22 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:DIAZ FAMILY CHILD CAREFACILITY NUMBER:
426215812
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 1DATE:
09/18/2020
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
03:05 PM
MET WITH:Blanca DiazTIME COMPLETED:
03:40 PM
NARRATIVE
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On September 18, 2020 at 3:05 PM, Licensing Program Analyst (LPA) Laura Villanueva made an announced telephone call to Licensee to conduct a Case Management-Licensee Initiated inspection to increase capacity her child care license. LPA met with Blanca Diaz and advised her the purpose of the inspection. LPA advised licensee that due to COVID-19 and Department of Public Health (DPH) guidelines of social distancing, a tele-inspection will occur. LPA confirmed with licensee that she had video capabilities with her phone and switched to WhatsApp to conduct the inspection.

The home is a single story 3 bedroom and 2 bath home. The living room has a fire place that is covered by the changing table making it inaccessible tot the children. The main child care area is the living room and the hall bathroom. The bedrooms and the garage are off limits to the children. Licensee stated that there are no guns or weapons in the house. No toxins or hazards are accessible to the children in care. They are stored on top of the refrigerator. The fire inspection was completed on 8/20/20. Licensee's CPR first Aid certificate expires 5/22/21. Mandated reporter training was completed on 8/28/20.



A large license is effective today.

“Exit interview was conducted with Elizabeth Brunsell via tele-inspection, during which the report was explained. This report will be sent to Licensee via email with a read receipt or confirmation of receipt of email, which will act as the Licensee's signature.”
SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Laura VillanuevaTELEPHONE: (805) 722-5138
LICENSING EVALUATOR SIGNATURE:

DATE: 09/18/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2020
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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