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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197493847
Report Date: 09/23/2021
Date Signed: 09/23/2021 10:11:03 AM

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:
197493847
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: DATE:
09/23/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Licensee Julie Martinez TIME COMPLETED:
10:30 AM
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On , 9/23/2021 at 9:00 am Licensing Program Analyst Lisa Rios went to the Martinez Family Child Care home for a capacity increase inspection for a large family child care . The facility has a completed 850 Fire Inspection report, a pull down fire alarm with light was added, no corrections are needed to the home.

LPA Rios completed a tour of the home inside and outside as well. Home is found to be in substantial compliance. A records file review of children present and licensee was conducted and all required forms are present including required licensing posted forms. The licensee will increase capacity for 14 children and a flyer was given to show how many children and their ages can be admitted to care.

Inside the home has substantial toys and equipment for the increase in children. There are two tables and 10 chairs to eat at and a single high chair in the kitchen with another in the garage. Licensee states there is one pack n play play pen and one crib in the garage, there are no infants at this time. There are 12 cots and 6 mats for older children to nap on.

A copy of this report will be given to the licensee and a new license will be emailed and sent in the mail.
SUPERVISOR'S NAME: Peter FloresTELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Lisa RiosTELEPHONE: (424) 301-3072
LICENSING EVALUATOR SIGNATURE:

DATE: 09/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2021
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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