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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376628543
Report Date: 01/08/2025
Date Signed: 01/08/2025 11:44:40 AM

Document Has Been Signed on 01/08/2025 11:44 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
SAN DIEGO CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:MARTINEZ, MICHELLE FAMILY CHILD CAREFACILITY NUMBER:
376628543
ADMINISTRATOR/
DIRECTOR:		MICHELLE MARTINEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 862-1037
CITY:CHULA VISTASTATE: CAZIP CODE:
91910
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 4DATE:
01/08/2025
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:00 AM
MET WITH:Genesis MartinezTIME VISIT/
INSPECTION COMPLETED:
11:55 AM
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On 01/08/2025 at 10:55AM, Licensing Program Analyst (LPA) Saul Zazueta conducted an unannounced plan of correction visit with licensee’s spouse, Genesis Martinez. LPA disclosed the purpose of the inspection and was led on a tour of the facility. There were four (4) children present during the time of inspection.

The purpose of the visit is to verify that the citations, cited on LPA Zazueta’s annual inspection dated 12/11/2024, have been addressed. During today's visit, LPA Zazueta found the following:

1) Licensee installed safety latches on the jacuzzi, located in the backyard, that locks the jacuzzi cover with a key, rendering it inaccessible to children in care.

LPA reviewed child records of the four children that were present and observed that four out of four children had a signed LIC9224 in their file in association with the citation issued on 12/11/2024. LPA also reviewed Genesis Martinez's personnel file and observed that CPR and Mandated reporter were up to date.

No deficiencies observed in the areas inspected during visit.

An exit interview was conducted with licensee's spouse, Genesis Martinez. Genesis was provided a copy of their appeal rights and a notice of site visit. Genesis was also provided a copy of the letter of Deficiency Citations Cleared. LPA Zazueta notified Genesis that the Notice of Site Visit must be posted for 30 Days from the date of this report.
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Saul Zazueta
LICENSING EVALUATOR SIGNATURE: DATE: 01/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/08/2025
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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