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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376628564
Report Date: 02/13/2020
Date Signed: 02/13/2020 11:15:24 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:MARTINEZ, ABIGAIN FAMILY CHILD CAREFACILITY NUMBER:
376628564
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: DATE:
02/13/2020
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Abigain MartinezTIME COMPLETED:
11:30 AM
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LPA, Luigi Gargaro, conducted an announced prelicensing inspection for a relocation with the applicant to ensure compliance with standards established in CCR, Title 22, Division 12, Chapter 3, for Family Child Care Homes. The one story home was toured and inspected to ensure an environment safe for the care and supervision of children. The fire extinguisher and smoke and carbon monoxide detectors meet requirements and are operational. All hazardous items were latched/locked and secured out of reach of children. The applicant was asked whether she had any bodies of water or weapons in the home and she replied no. CPR and First Aid expire on November 8, 2020 for the applicant. A review of staff records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions. Applicant rents the home and provided proof of control of property in the form of a lease agreement that is in the facility file.

Applicant will be using the following rooms for childcare: the front day care room, the living room and the day care bathroom. Off limits are the kitchen, the three home bedrooms, the second bathroom and the home garage. The kitchen is made off limits with a secured child safety gate that is installed in the entrance way between the living room and the kitchen. The first two home bedrooms are made off limits with door knob covers that are installed on their respective door handles. The third (master) bedroom and second bath are located behind the kitchen and are made off limits by the use of the kitchen safety gate. The garage is detached from the home and is otherwise inaccessible as it is in the off limits yard area. The applicant does have an operable wall heating unit but attests that it will not be used during day care hours and understands that if she decides to operate it in the day care, prior to its use, she must install a gate or other safety device around it to make it inaccessible to children in care. Applicant submitted a signed written declaration attesting to same. The applicant has sufficient toys and equipment available. The home has a side yard and drive way that applicant states are off limits to the day care as they are not appropriate care areas. Applicant will instead have children use her gated front patio for outdoor activities or take them to a local park whenever necessary.
SUPERVISOR'S NAME: Jason GarayTELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Luigi GargaroTELEPHONE: (619) 767-2229
LICENSING EVALUATOR SIGNATURE:

DATE: 02/13/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2020
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: MARTINEZ, ABIGAIN FAMILY CHILD CARE
FACILITY NUMBER: 376628564
VISIT DATE: 02/13/2020
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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm. LPA and applicant discussed California Megan's Law and he provided applicant with the website address: www.meganslaw.ca.gov for her to review information regarding her facility on a regular basis.

No corrections are required and a license for 8 will be issued today at this new location.
SUPERVISOR'S NAME: Jason GarayTELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Luigi GargaroTELEPHONE: (619) 767-2229
LICENSING EVALUATOR SIGNATURE:

DATE: 02/13/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2020
LIC809 (FAS) - (06/04)
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