192006918-10-31-2024-33-CC-SVAA-DAKUGM-20241031153434

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 192006918
Report Date: 10/31/2024
Date Signed: 10/31/2024 03:35:00 PM

Document Has Been Signed on 10/31/2024 03:35 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	DIAS FAMILY CHILD CARE		FACILITY NUMBER:	192006918
ADMINISTRATOR/ DIRECTOR:	DIAS, ETELBINA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(626) 797-8637
CITY:	PASADENA	STATE: CA	ZIP CODE:	91103
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 3	CENSUS: 1	DATE:	10/31/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:55 PM
MET WITH:	Etelbina Dias, Licensee		TIME VISIT/ INSPECTION COMPLETED:	03:45 PM

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	Licensing Program Analysts (LPA) Saul Valenzuela conducted an unannounced required inspection to the above facility. LPA met with Etelbina Dias, Licensee who guided analyst on a tour of the facility. Per Licensee, there are 3 children currently enrolled. There was one child present- Also present during the inspection was licensee’s husband and adult son. The licensee states that 3 adults currently live in the home. All adults present in the home have obtained a criminal record clearance or exemption prior to working, residing or volunteering in the licensed child care home. Licensee states that there are no firearms stored in the home. This is a two-story home which consists of 3 bedrooms, 2 bathrooms, kitchen, dining room, living room, front and backyard (fenced). This is a duplex property. The children use the bathroom on the first floor, kitchen, living room, one bedroom and dining room. Per licensee, areas off limits to children and parents include 2nd floor, there is a kiddie gate blocking access to the stairwell. LPA observed a fireplace located in the living room that was made inaccessible via a shelf barricade and gate. LPA toured all areas used by children during this visit. LPA observed all off-limits area to be inaccessible for children. Areas accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating or safety and comfort. There is telephone service via a landline and a cellphone. ----------------------------------------------- pg 1 of 4 -------------------------------------------------------------------

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Saul Valenzuela
LICENSING EVALUATOR SIGNATURE:	DATE: 10/31/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/31/2024

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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: DIAS FAMILY CHILD CARE	FACILITY NUMBER: 192006918
	VISIT DATE: 10/31/2024

NARRATIVE

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The following was observed and reviewed during this inspection.

Detergents, cleaning compounds, and medications were observed to be inaccessible to children. Per Licensee, they do not have any poisons in the home. The restroom that children use was observed to be safe and sanitary.

The valve on the required 2A 10BC fire extinguisher indicates fully charged- service tag indicated that fire extinguisher was serviced on 8/3/2023. Smoke and carbon monoxide detectors were tested and are operable. All homes shall conduct fire and disaster drills at least once every six months, and document the date and time of each drill. The last drill documented was conducted on 7/21/2024.

Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted in the kitchen.

The home is observed to be clean and orderly. There are toys available for children.

LPA discussed the safe sleep regulations with licensee facility representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee [or facility representative] of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.
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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Saul Valenzuela
LICENSING EVALUATOR SIGNATURE:	DATE: 10/31/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/31/2024

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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: DIAS FAMILY CHILD CARE	FACILITY NUMBER: 192006918
	VISIT DATE: 10/31/2024

NARRATIVE

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Currently, children are using the backyard for outdoor play time. The outdoor play area was observed to be fenced and gated. LPA observed that the outdoor yard has toys and other materials for children to play with. No bodies of water were observed on this day.

The licensee is observed to be operating within the license capacity limitations. Children’s records were reviewed, including emergency information and were observed to be complete.

Licensee states she is currently caring for 2 infants. LPA observed a sleep log and LIC 9227 for each infant.

At 2:30 pm LPA observed that the licensee’s and assistant's Mandated Reporter Training Certificate were not in their files. Per Licensee they were unaware that they needed to complete Mandated Reporter Training. LPA observed that the Licensee does have proof of immunization record.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. 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: https://www.ada.gov/resources/child-care-centers/.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Saul Valenzuela
LICENSING EVALUATOR SIGNATURE:	DATE: 10/31/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/31/2024

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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: DIAS FAMILY CHILD CARE	FACILITY NUMBER: 192006918
	VISIT DATE: 10/31/2024

NARRATIVE

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LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs, and/or any other item that fall into these categories are not permitted in a family child care facility.

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

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

During the exit interview, the LICENSEE Etelbina Dias, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process

Based on the LPA’s observations and records review, the following deficiencies listed on the attached LIC 809D (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Licensee Etelbina Dias.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Saul Valenzuela
LICENSING EVALUATOR SIGNATURE:	DATE: 10/31/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/31/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 10/31/2024 03:35 PM - It Cannot Be Edited

Created By: Saul Valenzuela On 10/31/2024 at 02:56 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: DIAS FAMILY CHILD CARE	FACILITY NUMBER: 192006918
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/31/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in 2 out of 2 staff did not have Mandated Reporter Trainig Certificates in their files, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 11/27/2024
	Plan of Correction
1 2 3 4	Per Licensee, they will omplete the training for Mandated Reporter and submit proof to LPA via email by POC due date.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Brandi VanOosten

LICENSING EVALUATOR NAME:

Saul Valenzuela

LICENSING EVALUATOR SIGNATURE:

DATE: 10/31/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/31/2024

LIC809 (FAS) - (06/04)

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