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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198012265
Report Date: 03/08/2022
Date Signed: 03/09/2022 08:27:39 AM


Document Has Been Signed on 03/09/2022 08:27 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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754



FACILITY NAME:MARIN FAMILY CHILD CAREFACILITY NUMBER:
198012265
ADMINISTRATOR:MARIN, ASTRIDFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 672-7630
CITY:WEST COVINASTATE: CAZIP CODE:
91792
CAPACITY:14CENSUS: 6DATE:
03/08/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Astrid Marin, LicenseeTIME COMPLETED:
02:30 PM
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Licensing Program Analyst (LPA) Thelma Razo conducted an unannounced Required - 1 Year on-site on 3/8/2022 and was greeted by Licensee Astrid Marin. A COVID-19 risk assessment was conducted prior to entry to the facility. LPA stated the purpose of the visit and provided LIC 126 Entrance Checklist to facilitate the inspection. LPA was guided to a tour by Licensee. This is a single-story home with 3 bedrooms, 2 bathrooms, kitchen, dining room, living room, attached garage, patio and back yard. There are 3 adult family members and one minor residing in the home. There were five children in care during the inspection. The licensee was observed to be operating within the licensed capacity and is not exceeding the required limitations.
All areas identified on the Facility Sketch were inspected to include the following:
· Childcare areas: Living area, dining area, bedroom 31, bathroom #1, kitchen, patio and backyard as outdoor play area.
· Off limit areas: Bedroom #2 and #3 and bathroom #2.
All areas used by children were inspected for safety, comfort, cleanliness, telephone, ventilation and heating (central). The licensees state that there are no poisons in the home. The licensees understand that any poisons must be locked with a key or combination lock. Detergents, cleaning compounds, medicines, sharp objects and hazardous items that can pose a danger to children are inaccessible in all areas of the home. The valve on the required 2A 10BC fire extinguisher indicates it was fully charged. Smoke and carbon monoxide combination detector in day care hallway were tested and were operable. Per licensee, there are no bodies of water and no firearms and ammunition on the premises. There is a dog on the premises. Per Licensee, her dog was vaccinated. There were toys observed for children. Posting requirements were observed to be posted at the time of inspection. Children's file was reviewed today.

Due to time constraints, LPA will return to complete the inspection. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Licensee Astrid Marin.
SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Thelma RazoTELEPHONE: (323) 981-3387
LICENSING EVALUATOR SIGNATURE:
DATE: 03/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/08/2022
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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