197492900-4-18-2023-54-CC-AMOY-CQZUK2-20230418153824

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197492900
Report Date: 04/18/2023
Date Signed: 04/18/2023 03:38:43 PM

Document Has Been Signed on 04/18/2023 03:38 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	MARTINEZ FAMILY CHILD CARE		FACILITY NUMBER:	197492900
ADMINISTRATOR:	MARTINEZ, JASMINE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(310) 427-0134
CITY:	COMPTON	STATE: CA	ZIP CODE:	90222
CAPACITY:	14	CENSUS: 3	DATE:	04/18/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:30 PM
MET WITH:	Jasmine Martinez, Licensee		TIME COMPLETED:	04:00 PM

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Licensing Program Analyst (LPA) Alicia Mooberry conducted a Required Annual Inspection on this date. Upon arrival at 12:30pm LPA met with Francisca Martinez, Assistant, and explained the purpose of inspection, LPA toured the home. There were three (3) children present upon arrival. Licensee Jasmine Martinez arrived at 12:59pm, LPA provided the inspection Entrance Checklist, LIC 126. Per licensee the current hours of operation are Monday-Sunday 6:00am-4:00am. The licensee offers overnight care, LPA discussed with licensee that "Overnight Care" means care being provided to children anytime between the hours of 6 p.m. and 6 a.m. Care provided during the day and overnight combined shall not exceed 24 hours from the time the child entered into care. All adults present have been cleared and associated. Individuals residing in the home were discussed and noted.

The home is a single story, two bedrooms and one bathroom. The home is clean, orderly, comfortable and well ventilate. The home has central air and heating. Per licensee, the areas used by children include: The living room, dining room, bathroom and back yard. Off limit areas are: Two bedrooms, detached garage.

Areas used by children were inspected for safety, comfort, cleanliness, telephone service, ventilation and heating. Rooms that are off-limits need to be made inaccessible during operating hours. LPA observed safety door knobs on bedroom doors. The licensee does understand that licensing staff may have access to off-limit areas during inspection visit if necessary.

LPA observed the facility license, Publication (PUB) 394- Notification of Parent Rights and Licensing Form (LIC) 9148- Earthquake Preparedness form posted in the living room in a location visible to parent/guardians of children in care. LPA observed completed facility records including; LIC 9040- Facility Roster, LIC 610- Facility Disaster Plan.

Page 1 Report Continues

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Alicia Mooberry	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 04/18/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2023

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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: MARTINEZ FAMILY CHILD CARE	FACILITY NUMBER: 197492900
	VISIT DATE: 04/18/2023

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The licensee provides food for children in care. LPA discussed food allergies and precautions.

Smoke and carbon monoxide detectors were tested and are operable. Fire extinguisher indicated fully charged and was serviced on April 2023, Licensee was reminded that fire extinguisher needs to be serviced yearly. The home maintains telephone service via cell phone.

The home is observed to be clean and orderly. There are toys and other age appropriate material available for children. LPA observed that cleaning compounds are in kitchen and bathroom inaccessible to children. The bathroom that children use is located in the observed to be clean and free of hazards.

Licensee states that there are no poisons stored in the home and understands that all poisons must be lock, not only inaccessible to children.

Per Licensee there are no firearms or weapons stored in the home.
Isolation area for sick children waiting to be picked up is in living room, away from the other children.

LPA informed licensee of the new Safe sleep regulations, including LIC 9227 Infant Sleep Plan for infants under 12 months, 15-minute sleep check documentation for infants 0-24 months, and provided PIN 20-24-CCP. Licensee states infants sleep in the living room, each infant has their own play yard. Staff supervise infant for the duration of the nap and will document 15 minute checks.

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.

Currently, children are using the back yard for outdoor play. The outdoor play area was observed to be fenced. LPA observed that the outdoor yard has toys and other materials. LPA did not observe any objects that could be hazardous to children in care. Facility does not have a pool or similar bodies of water. Licensee has two small dogs, observed in the kennel.

-------------------Page 2 – Report Continues

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Alicia Mooberry	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 04/18/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2023

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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: MARTINEZ FAMILY CHILD CARE	FACILITY NUMBER: 197492900
	VISIT DATE: 04/18/2023

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Children’s records were reviewed for (LIC) 282- Affidavit Regarding Liability Insurance, Immunization's Records, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights, and documentation of 15-minute Infant Sleep Check (0-24 months).

Licensee and Staff records were reviewed for approved Pediatric First Aid and CPR certification, LIC-501: Personnel Record, LIC 508-Criminal Record Statement, LIC 9052- Employee Rights, Proof of immunizations against measles, pertussis and influenza declination, TB clearance or risk assessment, LIC 9108- Statement Acknowledging Requirement to Report Child Abuse and current Mandated Reporter Training Certificate.

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

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.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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.

Based on the LPA's observations and records review no deficiencies will be cited today in accordance with California Title 22 Regulations.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Licensee, Jasmine Martinez

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Alicia Mooberry	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 04/18/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2023

LIC809 (FAS) - (06/04)

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