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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197418839
Report Date: 04/30/2025
Date Signed: 04/30/2025 03:49:21 PM

Document Has Been Signed on 04/30/2025 03:49 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
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:DIEGUEZ FAMILY CHILD CAREFACILITY NUMBER:
197418839
ADMINISTRATOR/
DIRECTOR:		DIEGUEZ, EDITH & ELSIEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 481-6858
CITY:PACOIMASTATE: CAZIP CODE:
91331
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 5DATE:
04/30/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:45 AM
MET WITH:Licensee Elsie Dieguez and Licensee Edith DieguezTIME VISIT/
INSPECTION COMPLETED:
04:00 PM
NARRATIVE
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On April 30, 2025, at approximately 9:45am, Licensing Program Analyst (LPA) Hanna Cha and Isabel Ortega met with Licensee Elsie Dieguez. Licensee Edith Dieguez arrived at the facility around 10:30am. The purpose of the visit was to conduct an unannounced Annual/Random inspection of the facility. LPA disclosed the purpose of the inspection to the Licensee. LPA toured and inspected the facility. LPA observed one licensee providing care and supervision to one infant and one preschool aged child at time of inspection. An additional three school-age arrived at approximately 3:00pm. There was a total of five children present. The current days and hours of operation are Mondays-Fridays; 6:00am-6:00pm.

Physical Plant: This is a one-story home with detached garage. There is a living room dining room, kitchen, three bedrooms, one restroom, a pool, front yard, and a back yard. Adults residing in the home are Licensee Edith Dieguez, Licensee Elsie Dieguez and Licensee Elsie Dieguez’s spouse.


Off-limit areas are the three bedrooms, kitchen, and backyard.


Continued on 809-C
NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Hanna Cha
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/30/2025
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 10
California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
Page: 2 of 10
Document Has Been Signed on 04/30/2025 03:49 PM - It Cannot Be Edited


Created By: Hanna Cha On 04/30/2025 at 01:43 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
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: DIEGUEZ FAMILY CHILD CARE
FACILITY NUMBER: 197418839

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/30/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102417(g)(5)(A)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (5) All licensees shall ensure the inaccessibility of pools (in-ground and above-ground), fixed-in-place wading pools, hot tubs, spas, fish ponds and similar bodies of water through a pool cover or 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 Division 1, Appendix Chapter 4 of the 1994 Uniform Building Code. In addition to meeting all of the aforementioned requirements for fences, 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. Pool covers shall be strong enough to completely support the weight of an adult and shall be placed on the pool and locked while the pool is not in use.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above in which poses an immediate health, safety or personal rights risk to persons in care. LPA observed a above-ground pool structure with no water at time of inspection. LPA observed entire gate was not consistently 5 feet tall. Shortest part of fence was only 58 inches in height.
POC Due Date: 05/30/2025
Plan of Correction
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Licensee will raise entire gate to meet 5 feet standard according to Title 22 regulations, purchase ASTM approved pool alarm, install key-lockable device 6 inches from the top of the gate, and re-install gate to swing away from the pool, and send photos as proof to PRO via email by 5/30/2025.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Lady King
NAME OF LICENSING PROGRAM MANAGER:
Hanna Cha
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 04/30/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/30/2025


LIC809 (FAS) - (06/04)
Page: 3 of 10
Document Has Been Signed on 04/30/2025 03:49 PM - It Cannot Be Edited


Created By: Hanna Cha On 04/30/2025 at 01:43 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
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: DIEGUEZ FAMILY CHILD CARE
FACILITY NUMBER: 197418839

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/30/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
HSC
1596.814(a)(1)(A)(i)
Pool Safety
(a) A licensed family daycare home operated at a private single-family dwelling with an in-ground swimming pool on the premises shall comply with all of the following requirements: (1) The swimming pool shall be equipped with, at minimum, the following drowning prevention safety features: (A) An enclosure, including, but not limited to, a fence, wall, or other barrier that isolates the swimming pool from access to the family daycare home and has all of the following characteristics: (i) An access gate that opens away from the swimming pool and is self-closing with a self-latching, key lockable device placed no lower than 60 inches above the ground.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation the licensee did not comply with the section cited above in which poses an immediate health, safety or personal rights risk to persons in care. Per LPA observation, there was no key lockable device installed. Gate did not open away from the swimming pool. Type A Violation issued.
POC Due Date: 05/30/2025
Plan of Correction
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Licensee will raise entire gate to meet 5 feet standard according to Title 22 regulations, purchase ASTM approved pool alarm, install key-lockable device 6 inches from the top of the gate, and re-install gate to swing away from the pool, and send photos as proof to PRO via email by 5/30/2025.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Lady King
NAME OF LICENSING PROGRAM MANAGER:
Hanna Cha
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 04/30/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/30/2025


LIC809 (FAS) - (06/04)
Page: 4 of 10
Document Has Been Signed on 04/30/2025 03:49 PM - It Cannot Be Edited


Created By: Hanna Cha On 04/30/2025 at 01:43 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
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: DIEGUEZ FAMILY CHILD CARE
FACILITY NUMBER: 197418839

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/30/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation the licensee did not comply with the section cited above in which poses/posed a potential health, safety or personal rights risk to persons in care. Per LPA observation, cleaning products were found on top of children cubbies in accessible area, on floor behind the couch in accessible area, and on top of the kitchen counter. Licensee immediately removed all cleaning products to an off-limits area. LPA advised licensee to implement best practice of putting away all cleaning products, out of children's reach.
Per LPA observation, there were two knives and a container of Tylenol on the kitchen counter. There was a door between the kitchen and children play area. However, the door was slightly open at time of inspection, making knives and Tylenol accessible to children. There was no child safety door knob installed on the door.
POC Due Date: 05/30/2025
Plan of Correction
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Licensee immediately removed cleaning products, Tylenol, and knives. Licensee will install a gate to barricade kitchen area in which cleaning compounds, sharp objects, knives, and medication will be stored. Licensee with take photos as proof and send via email to PRO by 5/30/2025.
Type B
Section Cited
CCR
102425(j)(2)(D)(c)
Infant Safe Sleep
Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following: Time of each 15-minute check

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and record review, the licensee did not comply with the section cited above in which poses/posed a potential health, safety or personal rights risk to persons in care. Per LPA record review, there was no documentation of infant sleep 15-minute checks. Licensee had a infant safe sleep template, but it was not completely filled out. Also, there was no documentation of previous safe sleep checks. Therefore, a Type B violation issued. LPA provided licensee with Infant Safe Sleep template.
POC Due Date: 05/30/2025
Plan of Correction
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Licensee will document safe sleep log for infant enrolled (0-24months) and send proof of two weeks of sleep log with required documentation to PRO via email by 5/30/2025.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Lady King
NAME OF LICENSING PROGRAM MANAGER:
Hanna Cha
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 04/30/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/30/2025


LIC809 (FAS) - (06/04)
Page: 5 of 10
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: DIEGUEZ FAMILY CHILD CARE
FACILITY NUMBER: 197418839
VISIT DATE: 04/30/2025
NARRATIVE
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Indoor/Children’s Area: The home was inspected for safety, comfort, cleanliness, and good repair. Per licensee, there are no poisons on the premises. LPA observed the furniture/equipment in good condition. LPA tested the dual carbon monoxide detector and fire alarm at 10:22am to be in operable condition. Per licensee, there is a working telephone service. There is an isolation area for children who become ill. The home maintains a comfortable temperature. Heating and ventilation in operable condition. LPA did not observe a fireplace. LPA observed safe and age-appropriate toys, play equipment and materials. LPA did not observe prohibited childcare items. The fire extinguisher was observed to be in operable condition. Per licensee, fire extinguishers are purchased yearly. LPA observed window screens in good repair. Per LPA observation, at time of inspection there were loose toys and objects spread out of floor (trip hazard). LPA advised licensee to ensure cleanliness when children are in care. A Technical Advisory issued. Per LPA observation, there were toys and a mat inside the crib. Licensee immediately removed the items from the crib. LPA advised licensee to keep crib clear of all loose items. At time of inspection, there was no infant in the crib.

Electrical outlets are inaccessible. LPA reminded licensee of prohibited toys and sleep/play equipment such as baby bouncers, saucer chairs, and any other recalled toys/equipment. Per licensee, there are no weapons/firearms on the premises. Naps are provided on cots in the living room (main care area).



Per LPA observation, cleaning products were found on top of children cubbies in accessible area, on floor behind the couch in accessible area, and on top of the kitchen counter. Licensee immediately removed all cleaning products to an off-limits area. LPA advised licensee to implement best practice of putting away all cleaning products, out of children's reach.

Continued on 809-C
NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Hanna Cha
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2025
LIC809 (FAS) - (06/04)
Page: 6 of 10
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: DIEGUEZ FAMILY CHILD CARE
FACILITY NUMBER: 197418839
VISIT DATE: 04/30/2025
NARRATIVE
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Bathroom: LPA observed childcare bathroom to be in safe and operating condition. Toilet and faucet are in good operable condition. Shower/Tub with glass enclosure. Toilet paper, paper towels, and soap were available to children. LPA reminded licensee to keep shampoos, mouthwash, razors, toothpaste, and other hazardous items inaccessible to children.

Kitchen: LPA inspected the kitchen for safety, sanitation, and good repair. LPA reminded Licensee, if food is brought from the child’s home, the container shall be labeled with the child’s name and properly stored or refrigerated. Licensee currently has a food program. Breakfast, lunch, snacks, and dinner are provided. Per LPA observation, there were two knives and a container of Tylenol on the kitchen counter. There was a door between the kitchen and children play area. However, the door was slightly open at time of inspection, making knives and Tylenol accessible to children. There was no child safety door knob installed on the door. A Type B violation issued. LPA advised licensee to install child safety door knob or child safety gate to ensure kitchen remains inaccessible to children.



Outdoor/Children’s Play Area: The front yard is utilized for outdoor play. LPA observed front yard for safety, age-appropriate toys, and good repair. The play area is gated all around. Per licensee, there are no pets on the premises. LPA reminded licensee to ensure that outdoor gates remain locked at all times.
Pools/Spa/Bodies of Water: Per LPA observation, there is a pool in off-limits backyard area. LPA observed an above-ground pool structure with no water at time of inspection. Per licensee, the pool ground is sand which licensee states "cannot hold water". Per licensee, there is no liner in the pool. LPA observed a ladder inside the pool structure. Licensee stated does not want to remove ladder. Gate did not open away from the pool and did not have a key-lockable device installed. Entire gate was not consistently 5 feet tall. Shortest part of fence was only 58 inches. At time of inspection, licensee did not have an ASTM pool alarm or pool cover. Licensee did not have documentation of daily pool checks. LPA informed licensee to raise gate to 5 feet all around, purchase ASTM approved pool alarm, install key-lockable device, and re-install gate to swing away from the pool, and document daily pool inspections. At time of inspection, LPA did not observe the back door leading to the pool to be locked. Licensee locked back door after LPA reminder. A Type A violation issued.

Per LPA observation, left side of pool is missing the metal fencing piece. A Technical Violation issued. LPA's observed items against the pool fence. A Technical Violation issued. LPA observed the pool is above ground and has sand. A Technical Violation issued. LPA observed one section of the pool fence is lower than 5 feet and door does not swing away from pool and lock is not six inches from the top with a lock. A Technical Violation issued. Continued on 809-C

NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Hanna Cha
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2025
LIC809 (FAS) - (06/04)
Page: 7 of 10
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: DIEGUEZ FAMILY CHILD CARE
FACILITY NUMBER: 197418839
VISIT DATE: 04/30/2025
NARRATIVE
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Other: First Aid Kit was observed. Per Licensee, there is no smoking in the home. Per recorded documentation, Fire/Disaster drill last completed on 3/18/25 at 5:00pm.

File Review: LPA reviewed one preschool child file, three school-age children files, and one infant file. All preschool and school age children files included all required documents. LPA reviewed Licensee files which included all required documentation. Facility rosters complete and maintained current. Pediatric CPR/First Aid expires on 02/1/2027.
Mandated Reporter training expires on 1/2027.
Per LPA record review, there was no documentation of infant sleep 15-minute checks. Licensee had an infant safe sleep log template, but it was not completely filled out. A Type B violation issued. LPA Cha provided licensee with Infant Safe Sleep log template.

Postings: LPA observed all required facility postings on premises: Notice of Parent's Rights Poster (PUB 394), Facility License (LIC 203), Emergency Disaster Plan (LIC 610A), and Fire/Earthquake Drill Log.



Documents Provided: Infant Sleep Log template

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

Continued on 809-C
NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Hanna Cha
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2025
LIC809 (FAS) - (06/04)
Page: 8 of 10
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: DIEGUEZ FAMILY CHILD CARE
FACILITY NUMBER: 197418839
VISIT DATE: 04/30/2025
NARRATIVE
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Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Any duly authorized officer, employee, or agent of the Department shall, upon presentation of proper identification, shall inspect the facility. The Licensee shall permit the Department to inspect the family childcare home, and to privately interview children or staff, to determine compliance with or to prevent violations of family child care laws or regulations. Also, to enter and inspect any place providing personal care,
supervision and services at any time, with or without advance notice, to secure compliance with, or to prevent a violation.

Licensee advised of the requirement to report Unusual Incidents. Licensee informed to utilize the Unusual Incident Report/Injury Report (LIC624B) when submitting a report to the department at: www.unusualincidentreport@dss.ca.gov. A report shall be made to the department by telephone or fax during the department's normal business hours before the close of the next working day following the occurrence during the operation of family day care home. In addition, a written report shall be submitted to the
department within seven (7) days following the occurrence of any events specified above.

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-andresources/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.

Continued on 809-C
NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Hanna Cha
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2025
LIC809 (FAS) - (06/04)
Page: 9 of 10
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: DIEGUEZ FAMILY CHILD CARE
FACILITY NUMBER: 197418839
VISIT DATE: 04/30/2025
NARRATIVE
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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02CCP. 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: https://www.ada.gov/resources/child-care-centers/.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, the licensee Edith Dieguez confirmed that there are no Registered Sex Offenders residing in the facility. On 4/30/2025, LPA completed the RSO profile in FAS via https://www.meganslaw.ca.gov/.


Two Type A violations, two Type B violations, five Technical Violations, and two Technical Assistance given at this inspection.

A Notice of Site Visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Licensee Edith Dieguez along with Appeal Rights.

Last Page

NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Hanna Cha
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2025
LIC809 (FAS) - (06/04)
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