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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191806680
Report Date: 05/17/2023
Date Signed: 05/17/2023 11:29:42 AM

Document Has Been Signed on 05/17/2023 11:29 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
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:DIAZ, MARIA AND IBOA, JORAM FAMILY DAY CAREFACILITY NUMBER:
191806680
ADMINISTRATOR:DIAZ, MARIA AND IBOA/JORAMFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 264-0340
CITY:LOS ANGELESSTATE: CAZIP CODE:
90023
CAPACITY: 14TOTAL ENROLLED CHILDREN: 9CENSUS: 3DATE:
05/17/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Licensee - Maria DiazTIME COMPLETED:
11:45 AM
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Licensing Program Analyst (LPA) R. Derraco conducted an unannounced required on year inspection to the above facility on 05/17/23. LPA arrived at the facility at 9:15 AM and met with licensee, Maria Diaz, who guided analyst on a tour of the facility. Also present during this inspection was co-licensee Joram Iboa. Per Licensee, there are 9 children that are currently enrolled. There were 3 children present upon arrival. *

This is a one-story home which consists of 2 bedrooms, 1 bathrooms, kitchen/dining room, living room, den, detached garage, front yard and backyard (fenced). The off limit areas include 1 bedroom, front yard and detached garage.

The main care area is located in the living room. LPA observed age appropriate toys, a play pen, a child sized couch, educational posters, and a reclining chair. Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted on a wall at the entrance to the facility. The kitchen/dining area was observed with a child sized table, child sized chairs, a dining table, a wall mounted television, art supplies and a children's storage cabinet. Knives and cleaning products were observed in a locked cabinet above the counter. Locks were also observed beneath the kitchen sink making contents inaccessible. The licensee understands that storage areas for poisons must be locked, not just inaccessible. Bedroom 2 has been converted to a children's play room. Additional age appropriate and sensory toys were observed in the bedroom. A den area was observed to have a sink, a wooden baby changing station, sleeping cots, and additional toys. The bathroom was observed to be clean with an operable sink, toilet,and faucet. The outdoor play area was observed with perimeter fencing. The licensee's vehicle was observed to be parked in the play area temporarily because of trash day. Additional toys and outdoor play equipment was observed in the backyard play area. The licensee states that she provides food for children in care. Licensees understand that food brought from home must be labeled and properly stored or refrigerated. Per licensee, isolation area for children showing signs of illness will be located in one of the rooms, away from the (page 1 of 3)
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE: DATE: 05/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/10/2023
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
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: DIAZ, MARIA AND IBOA, JORAM FAMILY DAY CARE
FACILITY NUMBER: 191806680
VISIT DATE: 05/17/2023
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group, while they wait for parent pick up. LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs. No bodies of water were observed in the back yard play area. A pet dog was observed behind a locked gate located in the backyard play area. Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.

Individuals who reside in the home were noted and discussed. 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. Licensee states that there are no firearms stored in the home

All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. There is telephone service via a landline. Per Licensee, the home is equipped with central heating. Ventilation was observed to be provided by a ceiling fan. The valve on the required 2A 10BC fire extinguisher indicates fully charged and was serviced on 10/21/22, as indicated on service tag. Smoke and carbon monoxide detectors were tested and are operable.



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.

The licensees has completed training on preventive health practices including Pediatric First Aid and CPR. The licensee's Pediatric First Aid and CPR expires on 11/09/2024. LPA observed that the Licensees have proof of the Mandated Reporter AB 1207 compliant Child Care Training Certificate on file. File review was observed to have proper mandated immunization records. Children’s records were reviewed, including emergency information and were observed to be complete. A current children’s roster was available for review.

(page 2 of 3)

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:

DATE: 05/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/17/2023
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
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: DIAZ, MARIA AND IBOA, JORAM FAMILY DAY CARE
FACILITY NUMBER: 191806680
VISIT DATE: 05/17/2023
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Incidental Medical Services (IMS):
IMS was discussed with licensee. Per licensee, there are no children enrolled that require IMS at this time. 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.

LPA advised the licensee to access forms, regulations and quarterly updates online at: www.cdss.ca.gov.

At this time, the licensee is in compliance with California Code of Regulations Title 22. No deficiencies cited.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the licensee Maria Diaz

(page 3 of 3)

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:

DATE: 05/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/17/2023
LIC809 (FAS) - (06/04)
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