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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197492900
Report Date: 04/18/2019
Date Signed: 04/29/2019 12:53:06 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:MARTINEZ FAMILY CHILD CAREFACILITY NUMBER:
197492900
ADMINISTRATOR:MARTINEZ, JASMINEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 427-0134
CITY:COMPTONSTATE: CAZIP CODE:
90222
CAPACITY:14CENSUS: 7DATE:
04/18/2019
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Jasmine MartinezTIME COMPLETED:
02:30 PM
NARRATIVE
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Licensing Program Analyst, V. Wheatley conducted an inspection and met with the licensee at 1:40PM. On April 12, 2019 LPA observed deficiencies during an inspection whereby there were 9 children present and 5 of the children were infants; Child #1, #2, #3, #4, #5. This is a risk to the health and safety in care. The maximum number of children allowed is four infants with a maximum of 12 children.

Today LPA observed 7 children on the premises watching television of which two are infants. The licensee's assistant is present. Licensee is operating within proper ratios.

Exit interview. Report provided.
SUPERVISOR'S NAME: Sharon GreeneTELEPHONE: (424) 302-3048
LICENSING EVALUATOR NAME: Veronica WheatleyTELEPHONE: (424) 301-3051
LICENSING EVALUATOR SIGNATURE:

DATE: 04/18/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2019
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 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: MARTINEZ FAMILY CHILD CARE
FACILITY NUMBER: 197492900
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/18/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/19/2019
Section Cited
CCR
102416.5(d)(1)
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Staffing Ratio and Capacity - For a Large Family Child Care Home, the maximum number of children for whom care may be provided at any one time when there is an assistant provider in the home, including children under age 10 who reside at the licensee's home and the assistant provider's children under age 10, shall be; Twelve children, no more than four of whom may be infants. LPA Wheatley observed 5 infants on the premises. This is a risk to the health and safety of children in care.
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Licensee will ensure that she is operating according to Title 22 Regulations at all times. Licensee will submit a plan of correction to the department by 4/19/19.
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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.
SUPERVISOR'S NAME: Sharon GreeneTELEPHONE: (424) 302-3048
LICENSING EVALUATOR NAME: Veronica WheatleyTELEPHONE: (424) 301-3051
LICENSING EVALUATOR SIGNATURE:

DATE: 04/18/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2019
LIC809 (FAS) - (06/04)
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