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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334841751
Report Date: 02/22/2023
Date Signed: 02/22/2023 11:14:20 AM

Document Has Been Signed on 02/22/2023 11:14 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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:DIAZ FAMILY CHILD CAREFACILITY NUMBER:
334841751
ADMINISTRATOR:MARIA ELENA DIAZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(951) 525-3084
CITY:RIVERSIDESTATE: CAZIP CODE:
92505
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
02/22/2023
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME BEGAN:
10:49 AM
MET WITH:Maria Elana Diaz & Lorena DiazTIME COMPLETED:
11:20 AM
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On date and time listed, Licensing Program Analyst (LPA) Justin Giese arrived at the facility to conduct a Case Management Health Check of the facility. Present during this inspection was Licensee, Maira Elana Diaz and Lorena Diaz. LPA did not observe any children or other adults other than those listed in this report present.

· A working telephone is present
· Appropriate fire extinguisher, smoke detector and carbon monoxide detector are present and were tested by the Licensee during this inspection
· All hazardous items are inaccessible, this includes detergents, cleaning compounds, medications and other items which could pose a danger
· Storage of poisons is inaccessible to and locked in attached garage.
· No guns or weapons present as stated by the Licensee. Licensee understands all guns, weapons and ammunition must be key-locked separately and made inaccessible per Title 22 regulations.
· Single story home, no stairs
· Home is clean and orderly, with heating and ventilation for safety and comfort
· Safe and appropriate toys and equipment are present for both indoor and outdoor activities.
· Outdoor play areas are fenced
· Facility Sketch, Emergency Disaster Plan & Notification of Parent’s Rights poster are posted
· There are no bodies of water, at this time. Licensee understands all bodies of water including ponds, above ground pools & spas, in-ground pools & spas, and some fountains must be properly covered or fenced per Title 22 regulations. The Department must be notified before and after installation of the above types of bodies of water. In addition, all wading pools or similar product must be emptied immediately after use and stored in an upright position.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Justin Giese
LICENSING EVALUATOR SIGNATURE: DATE: 02/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/22/2023
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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: DIAZ FAMILY CHILD CARE
FACILITY NUMBER: 334841751
VISIT DATE: 02/22/2023
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Licensee submitted LIC9211 Request for inactive status effective January 23, 2023. Licensee will not provide child care for which a license is required until their license is reactivated. Licensee will continue to pay the annual license fee by the annual date due. Licensee understands that failure to pay the annual license fees will result in the closure of the facility.

Licensee will inform the Licensing Office (RO) of any changes in the inactive dates by submitting a new LIC9211, before the expiration date. Licensee understands an annual inspection may be or is necessary prior to re-opening the facility and will contact the assigned analyst prior to reopening to schedule an inspection.

Licensee will comply with all, including new, licensing laws and regulations upon re-opening the facility, including but not limited to: Ensuring all adult staff, residents, and children who turn 18 during the inactive period, have criminal record clearances and TB.

Licensee will ensure compliance with all new legislation and/or regulations. Licensee will maintain current CPR, First Aid, and Mandated Reporter Certifications. Licensee will maintain a current fire extinguisher, carbon monoxide, and functioning smoke alarms and/or detectors.

An exit interview was conducted with Licensee, Maria Elena Diaz; a copy of this report and notice of site visit was issued.

Notice of site visit must remain posted for the next 30 day.

SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Justin Giese
LICENSING EVALUATOR SIGNATURE:

DATE: 02/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/22/2023
LIC809 (FAS) - (06/04)
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