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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376605870
Report Date: 10/25/2022
Date Signed: 10/25/2022 12:24:22 PM


Document Has Been Signed on 10/25/2022 12:24 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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501



FACILITY NAME:RENNER, ROBIN & MARTIN FAMILY CHILD CAREFACILITY NUMBER:
376605870
ADMINISTRATOR:RENNER, ROBINFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 721-6746
CITY:OCEANSIDESTATE: CAZIP CODE:
92054
CAPACITY:14CENSUS: 4DATE:
10/25/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:05 AM
MET WITH:Robin RennerTIME COMPLETED:
12:40 PM
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On October 25, 2022 at 09:51 AM, Licensing Program Analyst (LPA) Sumayya Habeebulla arrived at the facility to conduct a case management for the Restroom work that will be taking place at the facility soon.

The Restroom maintenance has not begun yet and Licensee will notify the Department once the date has been finalized for the work to begin. During the time period of the maintenance work, childcare children will be using the restroom located inside the Master Bedroom. LPA inspected the Master Bedroom and Restroom during today’s visit. Licensee has been advised to keep all items that need to be kept out of reach of children locked. Licensee was also advised to make a visual inspection of the Master Bedroom and Restroom before the arrival of the Childcare children. Licensee will be providing a written statement reflecting the requirement.


An exit interview was conducted, and this report was reviewed with the licensee Robin Renner. Appeal rights were discussed and provided during the exit interview.

A notice of site visit was given and Licensee understands it must remain posted for 30 days.
SUPERVISOR'S NAME: Carlos MartinezTELEPHONE: (951) 782-4950
LICENSING EVALUATOR NAME: Sumayya HabeebullaTELEPHONE: 951-201-1991
LICENSING EVALUATOR SIGNATURE:
DATE: 10/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/25/2022
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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