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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198017919
Report Date: 04/26/2022
Date Signed: 04/26/2022 03:52:29 PM

Document Has Been Signed on 04/26/2022 03:52 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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:MARTINEZ GIRON FCCFACILITY NUMBER:
198017919
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 7CENSUS: 7DATE:
04/26/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:44 PM
MET WITH:Licensee Viviana Martinez-GironTIME COMPLETED:
04:05 PM
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On 4/26/22 Licensing Program Analyst (LPA) Jeanette Estrada conducted an unannounced case management inspection for a capacity increase at the facility above LPA Estrada met with Licensee, Viviana Martinez- Giron who guided LPA on a tour of the facility. Operating hours will be Monday to Friday 6AM to 6PM and care will be provided for children ages 2 months to 12 years old. All residents living in the home were discussed and verified. There were 7 children present when LPA arrived. Fire clearance approval was granted on 4/18/22.

This is a one story 3 bedroom/1 bathroom home with a front yard, living room and kitchen. There are two additional homes on the property. This family child care home is the front unit. There is no garage as part of this unit.

Off Limit Areas: Two of the bedrooms in the home are off limits and are kept locked during operating hours.

On Limit Areas: One bedroom, living room, kitchen, bathroom and front yard. Areas accessible to children were inspected the for safety, comfort, cleanliness, ventilation and working phone (cell phone). The main day care area is in the first bedroom. Children nap and eat in the bedroom. LPA observed children napping on mats. LPA observed an infant play yard. The living room is also used by children in care. LPA observed an A/C unit in the living room and one in the bedroom. For heating, Licensee stated a portable heater is used and is kept inaccessible to children. The kitchen is not off limits since the home has an open layout. Per Licensee, children do not go in the kitchen area and they mainly stay in the day care room or the living room. The bathroom children use is next to the off limit bedrooms. Per Licensee, children are escorted to the restroom and assisted if needed. The outdoor play area is in the front of the home. It is shaded and fenced. Per Licensee, children are supervised when playing outside. LPA observed age appropriate furniture, toys and materials to be in good condition.

Detergents, cleaning compounds, sharp objects and hazardous items that can pose a danger to children are inaccessible to children in care. Knives and sharp objects are kept above the refrigerator.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE: DATE: 04/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/26/2022
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 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: MARTINEZ GIRON FCC
FACILITY NUMBER: 198017919
VISIT DATE: 04/26/2022
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Medicines are kept in an off limits bedroom. Per Licensee, currently no children enrolled require medications. Cleaning compounds are kept under the kitchen sink in a latched cabinet. Laundry detergent is kept above laundry area in the in the hallway inaccessible to children. Personal hygiene items in the bathroom are inaccessible to children and are kept in a latched cabinet. LPA did not observe any cleaning compounds in the bathroom. LPA observed covered electrical outlets throughout the day care areas. Per Licensee, there are no poisons in the home. LPA advised that if any poisons are kept in the home at a later date to keep them in a locked cabinet or container. The isolation area for when a child is ill is in the living room while waiting to be picked up. Per Licensee, children are provided with meals. Licensee was reminded that if food is brought from home, the container shall be labeled with the child's name and properly stored or refrigerated.
Per Licensee, there are no bodies of water on the property. LPA did not observe any bodies of water. Licensee states there are no weapons or firearms in the facility. LPA advised that if weapons or firearms are kept in the facility at a later date, they must be kept locked and the fire arm and ammunition must be stored separately. There is a pet dog in the home. Per Licensee, pet is kept outside while children are inside the home and inaccessible when children are outdoors. LPA observed a first aid kit and a 2A10BC fire extinguisher indicating it is full and serviced on 4/3/22. First aid kit and fire extinguisher are kept on the wall next to the dining table easily accessible to the Licensee. There is an operable smoke and carbon monoxide detector located in the daycare room. LPA observed the required postings: Facility License, PUB 394 Parent's Rights Poster, LIC 9148 Earthquake preparedness poster . LPA observed LIC 610 Emergency Disaster Plan, LIC 999 Facility Sketch, Emergency drill log with last drill conducted on 4/8/22. Licensee provided an updated facility roster.
Licensee has current pediatric CPR/First Aid which expires 10/2022, Mandated Reporter training which expires 11/3/2022 and required Health & Safety plus one hour nutrition and lead component completed. Licensee has required immunization vaccines on file for Measles, pertussis and influenza.
Infant Care: Currently licensee cares for 1 infant under 12 months. LPA observed 1 play yard visible in the day care room. Napping equipment does not block entrances or exits. Infant mattresses were observed to be firm with tightly fitted sheets. LPA did not observe loose object, bumpers, objects hanging, or objects attached to the cribs. There are currently no infants with pacifiers used during nap. Per licensee wet or soiled sheets are laundered at children's homes weekly or as needed. LPA and licensee discussed the new Safe sleep regulations, including LIC 9227 Infant Sleep Plan for infants under 12 months, 15-minute sleep check documentation for infants 0-24 months. Licensee states the following sleep supervision plan for infants: Infants nap during nap time and are supervised.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:

DATE: 04/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/26/2022
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: MARTINEZ GIRON FCC
FACILITY NUMBER: 198017919
VISIT DATE: 04/26/2022
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Incidental Medical Services (IMS):
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 Center and the ADA, available at: http://www.ada.gov/childqanda.htm
Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.
LPA discussed the safe sleep regulations with Licensee and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleephttps://www.cdss.ca.gov/inforesources/child-care-licensing/ public -information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

No deficiencies were cited today.
A large family child care licensee will be granted upon LPM approval. Once licensed, the applicant is required to comply with the terms and limitations stated on the license.

Exit interview conducted and report was reviewed with the Licensee, Viviana Martinez-Giron. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:

DATE: 04/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/26/2022
LIC809 (FAS) - (06/04)
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