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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393621408
Report Date: 07/17/2020
Date Signed: 07/20/2020 09:10:17 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME:MONTANEZ, MOLINAFACILITY NUMBER:
393621408
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 5DATE:
07/17/2020
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Molina MontanezTIME COMPLETED:
09:45 AM
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Due to COVID-19 pandemic, Licensing Program Analyst (LPA) Christopher Jackson is conducting a tele-video inspection via FaceTime with the Applicant Molina Montanez. The purpose of today's inspection, licensee has applied for a change of capacity from a small family home day-care to a large family home day care. All adult individuals subject to criminal background review have obtained a criminal record clearance and are cleared through the department.

During today's inspection, LPA conducted a virtual tour of all areas of the home accessible to children in care with the Licensee. The facility is a two story home with an open front yard and a completely fenced in backyard. The downstairs area of the home consists of a kitchen, dining room, living room, restroom, two bedrooms and garage. The second floor consists of one bedroom. Off-limit area include: entire upstairs, bedroom #1, garage and side yard with chickens. Licensee acknowledged that children may never enter these off-limit areas. During today's inspection LPA discussed large family child care home capacity limitations with licensee. Fire clearance has been approved by the Lodi Fire Department on 07/15/2020.

LPA observed cleaning supplies properly stored out of reach of children. LPA observed knives to be kept in a secured drawer and made inaccessible to children in care. LPA observed the stairway to the second floor is properly barricaded. During today's tele-inspection licensee stated there are weapons in the home. LPA Document Link Iconobserved the weapons to be stored according to Title 22 regulations. LPA observed a fire extinguisher in the home. LPA observed a functioning smoke detector, and carbon monoxide detector in the home during today's inspection. LPA discussed with licensee, that prior to making alterations or additions to the home or grounds,. The licensee shall notify the Department of the proposed changes. LPA observed a current CPR/First Aid certificate Exp 02/08/2022. LPA advised licensee to visit the licensing website at http://www.ccld.ca.gov for current forms, laws,regulations and legislation.

Effective today 07/17/2020, LPA is granting a large family child care license to serve 12 children (when there is an assistant present) with no more than 4 infants or capacity of 14 children when, 1 child is enrolled in Transitional kindergarten or above and 1 child at least age 6 with a maximum of 3 infants. Infants are children under the age of 2 years old.
SUPERVISOR'S NAME: Sharon OgbodoTELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Christopher JacksonTELEPHONE: (916) 216-8837
LICENSING EVALUATOR SIGNATURE:

DATE: 07/17/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2020
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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