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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426216183
Report Date: 04/06/2023
Date Signed: 04/06/2023 12:19:48 PM

Document Has Been Signed on 04/06/2023 12:19 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:RAMIREZ DIAZ FAMILY CHILD CAREFACILITY NUMBER:
426216183
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
04/06/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Jessica Ramirez DiazTIME COMPLETED:
12:30 PM
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On 4/6/23, at 9:15 AM, Licensing Program Analysts (LPAs) Elvin Baddley and Giovani Gonzalez conducted an unannounced One Year Required Inspection of the abovementioned Family Child Care Home (FCCH) as well as an inspection for the increase of capacity and the use of a guest room. LPAs met with Jessica Ramirez Diaz, Licensee of the FCCH and explained the purpose of the inspection. LPAs, in the company of Licensee toured the interior and exterior of the FCCH. The FCCH is a four bedroom, three bathroom single story dwelling. The FCCH’s living room, kitchen, hallway restroom and front yard are used for child care services, while the remainder of the home is excluded. LPAs observed no children on site during the course of the inspection.

Required forms are predominantly posted on the wall near the entry of the FCCH. The FCCH’s living room has a fireplace which is barricaded by plywood and a storage shelf. The FCCH's restroom used for child care is observed to be clean and free of toxins. LPA observed combination smoke and carbon monoxide detectors throughout the FCCH. The combination detector was tested in the guestroom at 10:09 AM and found to be operable. The FCCH has a regulation fire extinguisher on site which was purchased on 1/26/23. LPAs reminded the Licensee to either service or purchase a regulation fire extinguisher annually. The FCCH maintains working telephone services.

The FCCH was observed to be clean and orderly. The FCCH has ventilation to afford for the children’s comfort. The FCCH was void of hazardous items. Medication in the home is stored in excluded areas of the home which are inaccessible to children in care. Cleaning compounds are stored in a cabinet underneath the kitchen sink. Sharps are located in an evaluated cabinet in the kitchen area. Toys, furniture and equipment in the FCCH are age appropriate.

The front yard has a grassy play area and is enclosed by wooden fencing. The fence’s entry/exit gate is (CONT. 809-C, Page 2)
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE: DATE: 04/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/06/2023
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 3
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: RAMIREZ DIAZ FAMILY CHILD CARE
FACILITY NUMBER: 426216183
VISIT DATE: 04/06/2023
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secure. Toys and play equipment observed in front yard are age appropriate and in satisfactory condition. Licensee is reminded to replace toys and equipment which start to degrade. LPAs observed no bodies of water on site.

LPAs reviewed children's records. The records are current, complete and possessed emergency contact information as mandated by regulations. LIcensee has documentation memorializing child sleep checks in intervals of 15 minutes. A review of the FCCH's fire drill log show drills are current with the last occurring on 3/7/23. The Licensee's records are also current and complete with pediatric CPR and First Aid certifications expiring on 3/20/24. The Licensee's Mandated Reporter training certification expires on 4/5/25. Licensee is reminded to renew certifications and training prior to expirations. The Licensee informed LPAs no firearms or ammunition are stored on site.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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: http://www.ada.gov/childqanda.htm

Licensee was reminded that all adults 18 and over living or working in the home, 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 licensed Family Child Care Home. 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.

LPAs 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 for additional resource. LPAs 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.

The FCCH received a Fire Inspection Clearance from the Santa Maria Fire Department for a capacity of 14, (CONT. 809-C, Page 3)

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE:

DATE: 04/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2023
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: RAMIREZ DIAZ FAMILY CHILD CARE
FACILITY NUMBER: 426216183
VISIT DATE: 04/06/2023
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thus a change of capacity to a Large FCCH is granted. Likewise, the request to include a guest room for child care services is granted. A Notice of Site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Licensee Jessica Ramirez Diaz.

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE:

DATE: 04/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2023
LIC809 (FAS) - (06/04)
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