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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400668
Report Date: 02/24/2023
Date Signed: 02/24/2023 09:01:46 AM

Document Has Been Signed on 02/24/2023 09:01 AM - 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 S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:MARTINEZ FAMILY CHILD CAREFACILITY NUMBER:
198400668
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
02/24/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
08:19 AM
MET WITH:Erica MartinezTIME COMPLETED:
09:10 AM
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LPA Medel conducted an announced follow up pre-licensing appointment on 2.24.23. LPA ensured that corrections that were instructed from the pre-licensing meeting were done.

They are:

· Applicant installed an anchored barricade for the wall heater located in the main room where children exist.


· Applicant removed 4 large screws from the cement located next to the stairs that children would use to get to the back yard play area.
·Applicant added hand rails to the stairs both right and left so children can hold on when going down the stairs.
·Applicant replaced child safety locks with key locking device to every bedroom due to age of children to be cared for. Key locking device was also placed on cabinet where cleaning materials are inaccessible to children.
·Applicant installed a kiddie gate to prevent access to the kitchen,


A small family child care licensee will be granted upon final review of file and of application. Once licensed, the applicant is required to adhere to the terms and limitations stated on the license.

Exit interview conducted and report was reviewed with the applicant, Erika Martinez.

-End of Report

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Patricia Medel
LICENSING EVALUATOR SIGNATURE: DATE: 02/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/24/2023
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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