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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 214005559
Report Date: 10/19/2021
Date Signed: 10/20/2021 01:44:38 PM

Document Has Been Signed on 10/20/2021 01:44 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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:MARTINS, MEIRE R.FACILITY NUMBER:
214005559
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 2DATE:
10/19/2021
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Meire Rosa MartinsTIME COMPLETED:
10:50 AM
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Licensing Program Analyst (LPA) Haydee Caliboso met with licensee Meire Rosa Martins for increase in capacity requested by the licensee. The licensee stated that she is living in the home with her 9-year-old son. All adults living in the home have been fingerprinted cleared. The home is currently operating. Present during today’s inspection, 2 toddler children, a helper and the licensee. The licensee is operating within capacity requirements on this day. The hours of operations are from Monday - Friday, 8:00AM – 5:30PM. The licensee’s home is clean, orderly, and equipped with age-appropriate toys for children.

LPA inspected the home for health and safety hazards. The home has multiple smoke detectors, carbon monoxide detectors, and a fully charged fire extinguishers and a working telephone. All the cleaning solutions, poisons, and other chemicals that are dangerous to children are stored made inaccessible to children. The home has age-appropriate furniture. Furniture is steady and in good repair. The toilet and sink are in good working condition with proper sanitation in place. All materials and surfaces accessible to children are clean and toxic-free. The play yard including the upper and lower level are free of hazards; all the play structures are steady and in good repair. Home does not have a swimming pool, spa, hot tub, fishpond, or any other bodies of water, weapons, or firearms.

Capacity limits for a large family day care has been reviewed with the licensee. Licensee was reminded that when operating at a large capacity, there must be a helper present. Capacity limit resource was provided to the licensee.

Prior to approval of capacity increase; Licensee shall complete and submit verification of the following:
· Fire approval from Larkspur Fire Department.
· Proof of complete posting requirements are posted.
· LIC 9149
This report must be available in the facility for public review. Licensee was advised any additional questions to call Office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.cdss.ca.gov
SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Haydee R Caliboso
LICENSING EVALUATOR SIGNATURE: DATE: 10/19/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/19/2021
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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