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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020556
Report Date: 07/06/2020
Date Signed: 07/07/2020 06:35:24 PM

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:CAMPOS ARTZINIEGA FAMILY CHILD CAREFACILITY NUMBER:
198020556
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 0DATE:
07/06/2020
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Maite Campos ArtziniegaTIME COMPLETED:
11:00 AM
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Licensing Program Analyst (LPA) Crystal Green conducted an announced licensee-initiated case management tele-inspection at 10:30 AM via FaceTime due to COVID-19 and precautionary measures. The purpose of the tele-inspection was due to the licensee's request to increase to a Large Family Child Care Home. LPA Green identified herself and discussed the purpose of the call with the Licensee, Maite Campos Artziniega.

This is a home that consists of 2 bedrooms, 1 bathroom, living room, dining room, kitchen, laundry area, backyard, and garage. Family members residing in the home are 3 adults which include the Licensee, Licensee Husband, Licensee brother and 1 child. The licensee is caring for children from ages 3 months to 10 years of age. During this tele-inspection, the Licensee took this LPA on a tour of the home. At 10:35 AM, LPA was provided a tour through the interior of the home. LPA observed all off-limit bedrooms made inaccessible with child proof safety locks. LPA toured the areas accessible to children which were the living room, bathroom, and backyard. The licensee showed LPA the kitchen area which all cabinets and drawers in the kitchen were observed to have safety latches. LPA did not observe immediate hazards in the areas of the home accessible to the children in care. LPA was toured through the back-yard LPA observed the backyard to be surrounded by fencing and adequate cushioning in the play area.



At 10:40 AM, the tour resumed indoors where licensee showed LPA a current child roster and disaster drill log, last drill conducted on 06/02/2020. Application and file have been reviewed and are complete. There is an approved fire clearance on file. At this time, the licensee home meets the description of a safe and healthy environment for children as described in Chapter 1, Division 12, Title 22 of the California Code of Regulations, and will be submitted for approval to be licensed as a Large Family Child Care Home.

The exit interview was conducted with Licensee Maite Campos Artziniega, via tele-inspection. This report along with a copy of the appeal rights will be sent to the Licensee via email with a read receipt or confirmation of receipt of the email, which will act as the Licensee’s signature.

SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Crystal GreenTELEPHONE: (323) 854-5730
LICENSING EVALUATOR SIGNATURE:

DATE: 07/06/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/06/2020
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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