<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376629321
Report Date: 07/27/2023
Date Signed: 07/28/2023 06:59:37 AM

Document Has Been Signed on 07/28/2023 06:59 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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:CERVANTES, DIANA FAMILY CHILD CAREFACILITY NUMBER:
376629321
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 4DATE:
07/27/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
01:20 PM
MET WITH:Diana CervanesTIME COMPLETED:
03:30 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

On 07/27/23, at 1:20 p.m., Licensing Program Analyst (LPA) Cindy Meier conducted an unannounced case management inspection to issue civil penalty and cite deficiencies observed during an inspection conducted on 07/24/23. Upon arrival, LPA met with licensee, Diana Cervantes and explained the purpose of the visit. There were four (4) children present during the visit.

On 7/24/23, during a case management inspection LPA observed an above-ground pool present in the backyard of the facility. The side of the pool measured four (4) feet high, and LPA observed a pool ladder to be attached to the side wall. The pool was surrounded by a four (4) foot high wood picket fence, which did not meet licensing regulations. Licensee stated the pool was installed on 07/19/23 and water was added on 7/20/23 and 7/21/23. LPA determined that the licensee did not report the alteration of the grounds to the Department as required. The backyard is an off-limits area and made inaccessible to children by a locked sliding garage double door, two (2) locked side gates, and a lock on the house back door which is installed 5 inches below the top of the door. Additionally, the licensee removed the pool ladder and made it inaccessible to children by storing it in on the other side of the locked gate. Reporting requirements and pool regulations were discussed with the licensee. Licensee stated they would be installing a 5-6-foot-high fence with a gate that swings away from the pool and a self latching device located no more than six (6) inches from the top of the gate to comply with pool fencing regulations.

During today’s inspection, LPA observed the garage door locked, both side gates locked, the back door locked, and the pool ladder inaccessible to the children.
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Cindy Meier
LICENSING EVALUATOR SIGNATURE: DATE: 07/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/27/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: CERVANTES, DIANA FAMILY CHILD CARE
FACILITY NUMBER: 376629321
VISIT DATE: 07/27/2023
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
26
27
28
29
30
31
32
Per California Code of Regulations, (Title 22, division 12 & Chapter 3) one (1) Type A citation and one (1) Type B is being cited on the attached LIC 809-D.

LPA Cindy Meier informed Licensee, Diana Cervantes that this report dated 07/27/23 document(s) one (1) Type A citation(s) which shall be posted for 30 consecutive days as there is immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Cindy Meier informed the Licensee, Diana Cervantes to provide a copy of this licensing report dated 07/27/23 that documents Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

A $500.00 Immediate Civil Penalty was assessed (see LIC421IM) for an accessible body of water.

Exit interview conducted and report was reviewed with Licensee, Diana Cervantes. A copy of this report, along with Appeal Rights (LIC9058), were provided. A Notice of Site Visit was given and must remain posted for 30 days. LPA observed that the Notice of Site Visit was posted during the inspection. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Cindy Meier
LICENSING EVALUATOR SIGNATURE:

DATE: 07/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2023
LIC809 (FAS) - (06/04)
Page: 2 of 4
Document Has Been Signed on 07/28/2023 06:59 AM - It Cannot Be Edited


Created By: Cindy Meier On 07/27/2023 at 02:40 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
, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: CERVANTES, DIANA FAMILY CHILD CARE
FACILITY NUMBER: 376629321

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/27/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/02/2023
Section Cited
CCR
102417(g)(5)(A)

1
2
3
4
5
6
7
(g) The home shall be free from defects or conditions which might endanger a child.
Safety precautions shall include but not be limited to: (5)All licensees shall ensure the inaccessibility of pools (…above-ground)… by surrounding the pool with a fence.
(A)Fences shall be at least five feet high and shall be constructed so that the fence does not obscure the pool from view. The bottom and sides of the fence shall comply with…the 1994 Uniform Building Code. In addition…gates shall swing away from the pool, self-close and have a self-latching device located no more than six inches from the top of the gate…

This requirement is not met as evidenced by:
1
2
3
4
5
6
7
On 07/24/23, the licensee removed the pool ladder and stated it will be kept inaccessible to children by storing it behind a locked side gate. Side gates were locked and the backyard is made inaccessible by the back door lock, and the locked garage. Licensee stated they would be installing a 5-6-foot-high fence with a gate that swings away from the pool and a self latching device located no more than six (6) inches from the top of the gate to comply with pool fencing regulation.
8
9
10
11
12
13
14
Based on LPA observations and interview conducted, the licensee did not comply with the section cited above, as the above-ground pool was surrounded by a four (4) foot high wood picket fence which poses an immediate health and safety risk to children in care.
8
9
10
11
12
13
14
Licensee stated she will submit proof of the fence installation to CCLD by 08/02/23. A follow up inspection will be conducted to verify the correction.

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
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:Jason Garay
LICENSING EVALUATOR NAME:Cindy Meier
LICENSING EVALUATOR SIGNATURE:
DATE: 07/27/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/27/2023


LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 07/28/2023 06:59 AM - It Cannot Be Edited


Created By: Cindy Meier On 07/27/2023 at 02:47 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
, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: CERVANTES, DIANA FAMILY CHILD CARE
FACILITY NUMBER: 376629321

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/27/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/04/2023
Section Cited
CCR
102416.3(a)(3)

1
2
3
4
5
6
7
(a) Prior to making alterations…to a family childcare home or grounds, the licensee shall notify the Department of the proposed changed including…the following: (3)Installation of…above-ground swimming pools…

This requirement is not met as evidenced by:

1
2
3
4
5
6
7
Licensee stated she will submit an updated LIC999 Facility Sketch (yard), and she will review the CCLD training video, Child Care Reporting Requirements and provide a written summary to CCLD by 08/04/23.
8
9
10
11
12
13
14
Based on LPA observations and interview conducted, the licensee did not comply with the section cited above as the licensee installed an above-ground swimming pool on 07/19/23 and did not report the alteration to the grounds changes which poses a potential health and safety risk to children in care.
8
9
10
11
12
13
14
LPA provided website where training can be found. https://ccld.childcarevideos.org/family-child-care-providers/

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
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:Jason Garay
LICENSING EVALUATOR NAME:Cindy Meier
LICENSING EVALUATOR SIGNATURE:
DATE: 07/27/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/27/2023


LIC809 (FAS) - (06/04)
Page: 4 of 4