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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406215685
Report Date: 12/16/2021
Date Signed: 12/16/2021 03:37:38 PM

Document Has Been Signed on 12/16/2021 03:37 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
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:DIAZ FCC AKA WAYS OF ALOHA DAYCAREFACILITY NUMBER:
406215685
ADMINISTRATOR:JESSICA DIAZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 471-5224
CITY:PASO ROBLESSTATE: CAZIP CODE:
93446
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
12/16/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Jessica DiazTIME COMPLETED:
04:00 PM
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On 12/16/21 at 1:00 PM, Licensing Program Analyst (LPA) Francisca Velazquez conducted an unannounced Annual/Random Inspection. Prior to entering the facility, LPA conduct COVID-19 pre-screening questionnaire and based on Licensee's responses it was determined that the facility is safe and free of any COVID-19 exposures. LPA met with Jessica Diaz, Licensee of the facility and informed the Licensee the reason of today's inspection. During this inspection there were nine (9) children present along with Assistant, Ninette Wright. Licensee communicated that children have access to the living room, day-care room, dining area, one (1) bedroom used for infant napping and diaper changing, restroom in the hallway and backyard.

LPA observed all required forms are posted by the facility entrance. LPA observed a fire place that is made inaccessible by child care equipment. LPA observed two small gates blocking off the kitchen making the kitchen area inaccessible to children in care. LPA observed the restroom being used by children is clean and free of toxins. LPA observed a smoke alarm and carbon monoxide alarm in the hallway of the facility. Both detectors were not tested due to children napping. Both detector had flashing green light indicating that they were operational. LPA observed a fire extinguisher that was serviced on 9/18/20. Licensee stated that she has an appointment with the Fire Marshall to service the fire extinguisher on 12/20/21. LPA reviewed emergency drill log and observed that the last drill was conducted on 9/10/21. Licensee stated there are no firearms or ammunition in the home. No bodies of water were observed in the facility.

LPA reviewed children files for all children present in the facility during inspection. All children files were current. Licensee advised there were no children in care that required Incidental Medical Services. LPA reviewed Licensee's file and found that Licensee CPR/first-aid is valid through 6/24/22. Licensee's AB1207 is current and valid until 4/13/23. LPA reviewed Assistant's file and found that CPR/First-aid is current and valid until 10/27/22 and AB1207 is valid and current until 4/14/23.
CONT 809-C
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE: DATE: 12/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/16/2021
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, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: DIAZ FCC AKA WAYS OF ALOHA DAYCARE
FACILITY NUMBER: 406215685
VISIT DATE: 12/16/2021
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This facility does not provide Incidental Medical Services – IMS. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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: http://www.ada.gov/childqanda.htm
No deficiencies were cited during today's inspection.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

Licensee was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with licensee [or facility representative] 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.

A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2021
LIC809 (FAS) - (06/04)
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