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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304314238
Report Date: 02/21/2025
Date Signed: 02/21/2025 09:36:46 AM

Document Has Been Signed on 02/21/2025 09:36 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
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:RODRIGUEZ, ERIKENDY & MARTIN, SEANFACILITY NUMBER:
304314238
ADMINISTRATOR/
DIRECTOR:		RODRIGUEZ, E. & MARTIN, S.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(949) 979-0252
CITY:IRVINESTATE: CAZIP CODE:
92618
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 5DATE:
02/21/2025
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:35 AM
MET WITH:Licensee, Sean MartinTIME VISIT/
INSPECTION COMPLETED:
09:40 AM
NARRATIVE
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A Plan of Corrections site inspection was conducted on this day, 02/21/25 by LPA Sun. Met with licensee, Sean Martin who guided the analyst on a tour of the facility. Census was taken as follow: 3 infants and 2 preschool children.

The deficiency that was previously cited on the LIC9099 dated 02/03/25 has been cleared.

1. LPA observed 5 children present during today's visit. Facility within ratio.
2. LPA observed cribs/playpen free of loose items.
3. LPA observed completed LIC9224 for enrolled facility children.

LPA observed the Notice of Site Visit, the LIC9099 Complaint Investigation Report, and the LIC9099D from the previous inspection dated 02/03/25 posted by the main entrance. Acknowledgement of Receipt of Licensing Reports LIC 9224 was also observed in each of the child's file.

No deficiency was observed during today’s inspection, or the following deficiency was observed and cited during today’s inspection.

A new Notice of Site Visit dated 02/21/25 was posted today and licensee was explained that it must remain posted for 30 operation days. Failure to keep A Notice of Site Visit posted will result in a $100.00 civil penalty.
Web address for downloading forms or regulations was provided as (http://ccld.ca.gov/PG411.htm).
Exit interview was conducted, and a copy of this report was provided to licensee. Appeal Rights explained. The Licensee was provided a copy of the appeal rights (LIC 9058 01/2016) and their signature on this form acknowledges receipt of these rights. First level appeal is to the Regional Manager address is above on report.
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Cynthia Sun
LICENSING EVALUATOR SIGNATURE: DATE: 02/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/21/2025
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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