<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 163910602
Report Date: 02/03/2020
Date Signed: 02/04/2020 09:19:16 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:MARTINEZ, MARIA FAMILY CHILD CAREFACILITY NUMBER:
163910602
ADMINISTRATOR:MARTINEZ, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 572-5717
CITY:HANFORDSTATE: CAZIP CODE:
93230
CAPACITY:14CENSUS: 1DATE:
02/03/2020
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
01:05 PM
MET WITH:Maria MartinezTIME COMPLETED:
02:00 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
 On 2/3/2020, Licensing Program Analyst (LPA) Kathy Pacheco and LPA Ruby Ocegueda conducted an unannounced annual/random inspection. LPAs met with Licensee, Maria Martinez (Spanish Speaking), who provided a tour of the home, inside and outside, as shown on the facility sketch. There were no "bodies of water" of firearms in this facility. Poisons, cleaning compounds, medications and other hazardous items were inaccessible to children. The fireplace was made inaccessible to day care children. The fire extinguishers, smoke detectors, and carbon monoxide indicator met Community Care Licensing (CCL) regulations. The home was kept clean and orderly, with heating and ventilation for safety and comfort. There were no stairs in the home. Safe toys and play equipment were observed. There were no animals in the home. Licensee had a working telephone and the above telephone number was verified. Adequate supervision was being provided during this inspection. Outdoor play areas are fenced or supervised by the Licensee or care giver. Capacity as specified on the license was being maintained. Children’s records contained all emergency information specified by regulation. There were no excluded individuals present at this home. All adults who reside or work in the home had a criminal record clearance or exemption as indicated on LIS 531 – Facility Personnel Report Summary. The Licensee and other personnel as specified completed training on preventative health practices including pediatric CPR and first aid; Expires: 10/5/2021. Incidental Medical Services (IMS) policy was discussed. Licensee is aware that an IMS plan is required to be submitted to the Licensing office if they provide any of these services. LPAs provided Licensee with information regarding the California Department of Social Services (CDSS) Provider Information Notices (PINs) communication system and information regarding Safe Sleep Regulations.

Business hours are Monday through Friday 4:00 AM to 6:00 PM and other hours as arranged.

Per Title 22 of the California Code of Regulations no deficiencies were observed. LPAs conducted exit interview with Licensee and provided her with copies of this report and the Notice of Site Visit (required to be posted for 30 days).
SUPERVISOR'S NAME: Michael DuarteTELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Kathy PachecoTELEPHONE: (559) 341-5116
LICENSING EVALUATOR SIGNATURE:

DATE: 02/03/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2020
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 1