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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343625386
Report Date: 01/03/2024
Date Signed: 01/03/2024 09:52:42 AM

Document Has Been Signed on 01/03/2024 09:52 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:MARIN, MARIA ELENAFACILITY NUMBER:
343625386
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 7DATE:
01/03/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Maria MarinTIME COMPLETED:
10:10 AM
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Licensing program Analyst (LPA) Christopher Bello arrived at the facility at approximately 9:10am and met with the licensee Maria Marin for the purpose of a capacity increase from 8 to 14 children. LPA Bello toured all areas of the home that are accessible to children, today’s census included eight children. Also present during today’s inspection was daughter, who has been fingerprint cleared through Community Care Licensing.

Off-limit areas include: entire upstairs, garage, children’s room and backyard with pool.. Licensee acknowledged that children may never enter these off-limit areas.

LPA observed a current roster of the enrolled children and fire drill log The Fire Safety Inspection Clearance has been received from the 12/27/2023 Fire department, Sacramento, CA and the home has been cleared for up to 14 children.

Licensee acknowledges that when there is no assistant present, facility will revert back to the small capacity. Licensee acknowledges that children residing in the home under the age of 10 years shall be included in capacity.

In the areas that were evaluated, no deficiencies were observed at the time of the visit.

Effective today, 1/3/2024, LPA is granting a license to serve 12 children (when there is an assistant present) with no more than 4 infants or capacity of 14 children when 1 child in kindergarten or elementary school and 1 child at least age 6 and a maximum of 3 infants. Infants are children under the age of 2 years old. No Title 22 Deficiencies observed in the areas that were evaluated. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee [or facility representative] Maria Marin.
SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Christopher Bello
LICENSING EVALUATOR SIGNATURE: DATE: 01/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/03/2024
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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