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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 214005515
Report Date: 01/30/2024
Date Signed: 01/30/2024 12:33:37 PM

Document Has Been Signed on 01/30/2024 12:33 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
SAN BRUNO CC RO, 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: 14TOTAL ENROLLED CHILDREN: 13CENSUS: 8DATE:
01/30/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Licensee, Reina Catzim DiazTIME COMPLETED:
12:50 PM
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On January 30th, 2024, at approximately 9:30am, Licensing Program Analyst (LPAs) Leslit Tapia-Mandujano and Melissa Zaragoza arrived at the facility to conduct an annual inspection. LPAs was granted entrance by Licensee. LPAs explained the purpose of the inspection. LPAs met with licensee, Reina Catzim Diaz. Present in the facility were licensee, licensee and licensee's assistant supervising 8 children (3 infants and 5 preschool age child). Facility is operating within capacity limits on this day. All adult living and working in the home are fingerprint cleared and associated.

Licensee rents home, which is a 2 bedroom, 1 bathroom, single level. Licensee lives husband and two minor children. Hours of operation are Monday-Friday from 8am-4:30pm. Daycare areas are: Living Room, Bedroom #1 and Bedroom #2 (napping only), Bathroom #1, Kitchen (pass through only), (converted) Garage, and Backyard. Off limit areas are: Laundry area (in Garage), Front yard. All off limit areas, including closets, are properly barricaded.

LPAs toured day care areas of home with Licensee to inspect for health and safety hazards. LPAs observed home to be clean and in good repair with proper temperature and ventilation. There were a variety of age appropriate toys and equipment in the home which were in good condition. Home does not have a fireplace. Licensee has a pet bunny kept in the converted garage. There are no pools, and bodies of water in the premises. Per licensee, she will occasionally have water play and will dump all the water out after every use. All cleaning supplies, poisons and other chemicals were stored inaccessible to children. Discipline Policy was discussed. Infant children sleep in cribs in the bedrooms. Per licensee, she currently does not have children who sleep in the cribs. LPAs reminded licensee about safe sleep regulations.

There was a fully charged fire extinguisher, smoke alarm and carbon monoxide alarm, and a working telephone on site. Phone number listed for Licensee is current. Per Licensee, there are no weapons/firearms in the home. LPAs reviewed six children's' record which were complete. LPAs also reviewed facility and employee records. Licensees CPR & First Aid Certificate will expire 07/2025. Licensee's Mandated Reporter Training has since expired and needs to be renewed. Last Emergency drill was conducted 08/2023. Emergency drills must be conducted at least once every six months and should be properly logged.


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SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano
LICENSING EVALUATOR SIGNATURE: DATE: 01/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/30/2024
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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: CATZIM DIAZ, REINA G.
FACILITY NUMBER: 214005515
VISIT DATE: 01/30/2024
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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

Licensee was reminded that all adults 18 and over, 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 Child Care Center. 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.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee 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.

Incidental Medical Services (IMS) policy was discussed. Licensee does not have any children enrolled who use medication. 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.

During the exit interview, the licensee, Reina Catzim DIaz, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS on 01/30/2024.

No deficiencies were cited today under CCR, Title 22, Div. 12, Chapt. 1.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed and translated to Spanish by LPA Tapia-Mandujano with licensee, Reina Catzim Diaz.
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano
LICENSING EVALUATOR SIGNATURE:

DATE: 01/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/30/2024
LIC809 (FAS) - (06/04)
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