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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073408307
Report Date: 12/04/2024
Date Signed: 12/04/2024 11:27:50 AM

Document Has Been Signed on 12/04/2024 11:27 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, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:WALLE-ULLOA, MARTAFACILITY NUMBER:
073408307
ADMINISTRATOR/
DIRECTOR:		WALLE-ULLOA, MARTAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 610-1592
CITY:RICHMONDSTATE: CAZIP CODE:
94806
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 6DATE:
12/04/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Marta Walle-UlloaTIME VISIT/
INSPECTION COMPLETED:
11:35 AM
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On December 4, 2024 at 9:30am Licensing Program Analyst (LPA) Indira Loza met with Licensee Marta Walle-Ulloa for a Random/Annual inspection. Present during the inspection was the Licensee, Assistant Jennifer Walle, 5 preschool age children and two infants. Living in the home are the Licensee and her husband, Raul Torres. LPA toured the home for a Health and Safety check. The facility operates from 6am-6pm Monday – Friday.

The home is a two story house consisting 5 bedrooms, 3 bathrooms, living room, family room, den, laundry room, garage and fully fenced in backyard. The home is neat and clean with central heating and ventilation for safety and comfort.

On Limit Areas - downstairs bedroom at the end of the hallway on the right, den across from the downstairs bedroom, downstairs bathroom, family room, dining area, upstairs bedroom straight and to the left of the stairs which is used as the infant nap room, kitchen, and backyard.
Off Limit Areas - 3 bedrooms and two bathrooms located on the second floor, living room, garage, and laundry room
Isolation Area - In the Den

The inside of the home is observed to be neat, clean with ample age-appropriate materials for the children. All toxins and cleaning products were observed to be in inaccessible areas. Licensee stated she provides all food for the children. Licensee uses a child sized table for the children to do arts and crafts and to eat at - the table and chairs were observed to be clean and well maintained. LPA observed one crib on the second floor used for sleeping which was observed to be well maintained. Off limit areas are made inaccessible with closed doors and/or locks and visual supervision. LPA observed a gate at the top and bottom of the stairs to keep children under five years old from accessing the stairs. Licensee stated she will transport children from the nearby elementary school if needed.
Mayla MendozaTELEPHONE: (510) 292-9724
Indira LozaTELEPHONE: 510-368-3672
DATE: 12/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/04/2024
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, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: WALLE-ULLOA, MARTA
FACILITY NUMBER: 073408307
VISIT DATE: 12/04/2024
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The home has one (1) fully charged 3A40BC fire extinguisher in the kitchen. There is one (1) working carbon monoxide detector next to the main entrance area and one (1) smoke detector at the end of the downstairs hallway. All smoke detectors are connected to each other. The fireplace in the family room is blocked by furniture making it inaccessible to the children in care. The backyard is fully fenced with ample materials for the children in care. There were no harmful bodies of water in or around the home. The Licensee will utilize the backyard and the local park for outdoor play.

The facility is operating within its licensed capacity and is in ratio. Licensee’s Health and Safety training has been completed and EMSA approved Pediatric CPR & First Aid has been completed and expires on July 2026. Fire/disaster drills have been conducted and recorded with the last drill logged 12/4/24. LPA obtained the children’s files, helpers files, and facility files.

Licensee was reminded that California law requires Licensees to report unusual incidents and/or injuries to children in care, to the child's parents, and to the Department within 24 hours by phone. Within seven (7) days from the incident, Licensee’s must submit the Unusual Incident/Injury form (LIC 624B) to the Department. Licensee was reminded that any structural changes or additions to the home must be reported to Community Care Licensing. Children’s Roster must be properly maintained, and fire/disaster drills must be conducted every six (6) months and documented. Licensee was reminded that EMSA approved Pediatric CPR & First Aid training must be completed every two (2) years. Licensee was also informed that Mandated Reporter Training ("Child Care Providers") is required for all staff and is to be renewed every two (2) years by visiting https://mandatedreporterca.com/. LPA informed Licensee that all forms can be downloaded at www.ccld.ca.gov.



The Licensee currently does not provide Incidental Medical Services. Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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/.
SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 292-9724
LICENSING EVALUATOR NAME: Indira LozaTELEPHONE: 510-368-3672
LICENSING EVALUATOR SIGNATURE:

DATE: 12/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2024
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, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: WALLE-ULLOA, MARTA
FACILITY NUMBER: 073408307
VISIT DATE: 12/04/2024
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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.

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

During the exit interview, Licensee Marta Walle-Ulloa, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

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 provided the Licensee with a copy of the Infant Safe Sleep Regulations.

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.

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.

There were no deficiencies cited during today's visit.
A notice of site visit was given and must remain posted for 30 days.
Exit interview conducted and report was reviewed with the Licensee Marta Walle-Ulloa.
SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 292-9724
LICENSING EVALUATOR NAME: Indira LozaTELEPHONE: 510-368-3672
LICENSING EVALUATOR SIGNATURE:

DATE: 12/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2024
LIC809 (FAS) - (06/04)
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