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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304312981
Report Date: 07/11/2023
Date Signed: 07/12/2023 07:14:14 AM


Document Has Been Signed on 07/12/2023 07:14 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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868



FACILITY NAME:MARQUEZ, ANGELINAFACILITY NUMBER:
304312981
ADMINISTRATOR:MARQUEZ, ANGELINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(714) 917-5849
CITY:ANAHEIMSTATE: CAZIP CODE:
92802
CAPACITY:14CENSUS: 2DATE:
07/11/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
03:02 PM
MET WITH:Angelina Marquez, LicenseeTIME COMPLETED:
04:00 PM
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Licensing Program Analyst (LPA) P Rivas conducted an unannounced annual inspection and was assisted by licensee Ms. Angelina Marquez. Upon entrance LPA viewed two children in place (one school age and one infant).

The facility is a two story, 4 bedroom, 2 1/2 bathroom home located in a residential neighborhood. The off limit areas include upstairs and kitchen, garage and part of outside patio. Childcare areas include living room, dining room, 1/2 bathroom, den and backyard. LPA noted an inaccessible fireplace in den. There is at least one working carbon monoxide, smoke detector, and fire extinguisher in the home that meet statutory and State Fire Marshall standards. Detergents, cleaning compounds, medicines, and other items which could pose a danger if readily available to children were stored inaccessible to children. Licensee stated there are no firearms and/or other dangerous weapons in the facility, and none were observed during today's inspections. The home has age appropriate toys for the ages served. During today’s inspection LPA verified there is a working phone service. There were no poisons or other items observed which could pose a danger to children or if they were observed, they were locked or inaccessible. There are no bodies of water on the premises

Due to time constraints only the physical plant tour of the inspection will be completed today. No deficiencies cited during this visit.

An exit interview was conducted with licensee Angelina Marquez. Appeal Rights were explained. The Licensee was provided a copy of appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days. First level appeals should be sent to the regional manager to the address listed above.
SUPERVISOR'S NAME: Rina LopezTELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Pat RivasTELEPHONE: 714-703-2800
LICENSING EVALUATOR SIGNATURE:
DATE: 07/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/11/2023
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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