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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198017919
Report Date: 10/17/2024
Date Signed: 10/17/2024 12:13:58 PM

Document Has Been Signed on 10/17/2024 12:13 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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:MARTINEZ GIRON FCCFACILITY NUMBER:
198017919
ADMINISTRATOR/
DIRECTOR:		VIVIANA MARTINEZ GIRONFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 707-6934
CITY:LOS ANGELESSTATE: CAZIP CODE:
90023
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 6DATE:
10/17/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:15 AM
MET WITH:Viviana MartinezTIME VISIT/
INSPECTION COMPLETED:
12:45 PM
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Licensing Program Analysts (LPAs) Joshua Ortega and Claudia Kam conducted an unannounced annual inspection to the above facility on 10/17/2024. LPAs arrived at the facility at 09:15 AM and met with Viviana Martinez, Licensee guided analyst on a tour of the facility. Per Licensee, there are 11 children that are currently enrolled. A current children’s roster was available for review. There were 6 children upon arrival. There was 3 adults present upon arrival. All adults present in the home have obtained a criminal record clearance or exemption prior to working, residing or volunteering in the licensed childcare home.

This is a one-story home which consists of 3 bedroom, 1 bathroom, kitchen/dining room, living room, front yard (fenced) and driveway.
The on limits areas are: The living room, bathroom and one bedroom
The areas off limits to children and parents include: 2 bedrooms

All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. Children nap in bedroom at entry to the facility right of the living room. LPAs observed cots and bedding. Per Licensee she launders the bedding every Friday or as needed. Children eat in the living room. Licensee provides food for children.

Currently, children are using the the living room and front yard for outdoor play time. The outdoor play area was observed to be fenced. LPAs observed that the outdoor yard has age appropriate toys, tables and chairs for activities, shaded area and other materials for children to play with. LPAs did not observe any objects that can pose a danger to children on the outdoor yard. The licensee states that supervision is always provided.

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SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Joshua Ortega
LICENSING EVALUATOR SIGNATURE: DATE: 10/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/17/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: MARTINEZ GIRON FCC
FACILITY NUMBER: 198017919
VISIT DATE: 10/17/2024
NARRATIVE
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 The licensee has completed training on preventive health practices including Pediatric First Aid and CPR. The licensee's Pediatric First Aid and CPR expires on 08/2026. LPAs advised that if a child shows signs of illness he/she/they shall be separated from other children.

Children’s records were reviewed, including emergency information and were observed to be complete.
The licensee does have proof of immunization against influenza, pertussis, and measles.
LPAs observed that the Licensee's Mandated Reporter AB 1207 compliant Child Care Training Certificate on file expires on 05/2026

All homes shall conduct fire and disaster drills at least once every six months, and document the date and time of each drill. Last drill documented was conducted on 10/1/2024. There is a cat on the premises kept in bedroom 2. LPAs did not observe any pools, spas, hot tubs, fish ponds, or similar bodies of water during the inspection. Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted. LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs, Trampolines and/or any other item that fall into these categories are not permitted in a family child care facility. Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.

LPAs consulted and explained Child Abuse Reporting, Never Shake a Baby, and Safe Sleeping practices.

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SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Joshua Ortega
LICENSING EVALUATOR SIGNATURE:

DATE: 10/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2024
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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: MARTINEZ GIRON FCC
FACILITY NUMBER: 198017919
VISIT DATE: 10/17/2024
NARRATIVE
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On this date, 10/17/24, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ

The following were discussed:
To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Licensee Viviana Martinez Giron was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

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SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Joshua Ortega
LICENSING EVALUATOR SIGNATURE:

DATE: 10/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2024
LIC809 (FAS) - (06/04)
Page: 3 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: MARTINEZ GIRON FCC
FACILITY NUMBER: 198017919
VISIT DATE: 10/17/2024
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LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://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.

This facility does not provides Incidental medical services

For IMS information see PIN 22-02-CCP. Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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: https://www.ada.gov/resources/child-care-centers/.
Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California

Based on this information the following deficiencies on the LIC 809 D are being cited today 10/17/2024

A notice of site visit was given and must remain posted for 30 days.



Exit interview conducted and report was reviewed with the licensee Viviana Martinez Giron.

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SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Joshua Ortega
LICENSING EVALUATOR SIGNATURE:

DATE: 10/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/17/2024 12:13 PM - It Cannot Be Edited


Created By: Joshua Ortega On 10/17/2024 at 11:17 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: MARTINEZ GIRON FCC
FACILITY NUMBER: 198017919

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/17/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/17/2024
Section Cited
CCR
102425(J)(D)

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(J)The provider shall supervise infants while they are sleeping:... Documentation shall be in the infant’s file...(D) Documentation shall include the following: Infants name, time of 15 min check and date This requirement was not met as evidence by:

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i will ask my assistantst for help with keeping log up to date abd current. Will provide safe sleep log 10/18/24 - 11/15/2024. Log will be provided to LPA BY 11/25/2024 to clear defeciency.
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Based on observation and record review , the licensee had partial 15 min sleep check for one 12 month old and none for two 2 year olds. Which poses potential health safety and personal rights risk to person in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Karen Chambers
LICENSING EVALUATOR NAME:Joshua Ortega
LICENSING EVALUATOR SIGNATURE:
DATE: 10/17/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/17/2024


LIC809 (FAS) - (06/04)
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