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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376629269
Report Date: 04/25/2023
Date Signed: 04/25/2023 03:46:43 PM

Document Has Been Signed on 04/25/2023 03:46 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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:MARTIN, HEIDI FAMILY CHILD CAREFACILITY NUMBER:
376629269
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 10CENSUS: 6DATE:
04/25/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Heidi MartinTIME COMPLETED:
04:00 PM
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On April 25, 2023, at 2:00 p.m., Licensing Program Analyst (LPA), Gloria Gonzalez conducted an unannounced case management inspection for the purpose of a capacity increase and met with the Licensee, Heidi Martin.  LPA disclosed the purpose of the inspection and was granted entry into the facility by the Licensee.  Licensee accompanied LPA inside and out of the facility during this inspection. The fire clearance for 14 children was granted on 4/11/23. Six (6) daycare children, two (2) staff members and Licensee's spouse were present in the facility during this inspection.  Licensee and assistant meet immunizations requirements. This facility is a one story, 3 bedroom, 2 bathroom house. Licensee accompanied LPA inside and out of the facility during this inspection. The following areas used for childcare are: Living room, dining room, kitchen, bathroom #1, master bedroom, backyard patio.  Off limits areas are bedrooms #2 and #3, bathroom bathroom #2 and #3, and are inaccessible through use of door knob covers.

The fire extinguisher, smoke detector, and carbon monoxide detector met requirements.  All hazardous items were inaccessible to children. The licensee has toys, play equipment and materials available.  The home has a fenced backyard patio available for outdoor activities.  LPA did not observe any bodies of water a the time of this inspection. Licensee stated there are no weapons in the home. A review of staff records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions.  Licensee’s First Aid and CPR certifications expire on 9/2023.  Licensee has required immunizations.  Licensee completed Mandated Reporter Training on 11/23/21. 3 out of 6 children’s records were reviewed and contain immunization documentation and Notification of Parent’s Rights form.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Gloria Gonzalez
LICENSING EVALUATOR SIGNATURE: DATE: 04/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/25/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: MARTIN, HEIDI FAMILY CHILD CARE
FACILITY NUMBER: 376629269
VISIT DATE: 04/25/2023
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LPA provided and discussed the following:  Report suspected child abuse and neglect, maintain children’s records according to regulation, post all required forms, and ensure that all adults residing or working in the home have criminal background clearances or exemptions.  Licensee was reminded that corporal punishment, smoking, exersaucers, bouncy seats, walkers, and jumpers and/or similar equipment are not allowed in daycare.  Licensee was also provided handouts with information regarding upcoming Safe Sleep Regulations/SIDS, Lead exposure and Shaken Baby Syndrome.  LPA and Licensee discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov. 

There is one crib or play yard for each infant who is unable to climb out of the crib or play yard.  Cribs or play yards are free from all loose articles and objects. Licensee physically checks on sleeping infants up to 24 months of age every 15 minutes.  An Individual Infant Sleeping Plan [LIC 9227 (3/20)] is maintained for each infant up to 12 months of age.  Licensee places infants up to 12 months of age on their backs for sleeping. LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource.

Please visit the Guardian web page and set-up your Guardian account. https://cdss.ca.gov/inforesources/cdss-programs/community-care-licensing/caregiver-background-check/guardian. If you have any questions regarding Guardian, please contact CDSS at email: guardian@dss.ca.gov

LPA discussed and provided Licensee with the following: child care advocates email address: childcareadvocatesprogram@dss.ca.gov . In addition, for general questions or questions regarding licensing requirements contact the Child Care Licensing Duty Line at (619) 767-2248.

LPA discussed the maximum number of children for whom care shall be provided when there is an assistant provider in the home, including children under age 10 who live in the licensee's home and the assistant provider's children under age 10, shall be either: Twelve (12) children with no more than four of whom may be infants or Fourteen (14) children, with at least two of the children with 1 child enrolled in kindergarten and 1 child at least six years of age and no more than three infants.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Gloria Gonzalez
LICENSING EVALUATOR SIGNATURE:

DATE: 04/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/25/2023
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: MARTIN, HEIDI FAMILY CHILD CARE
FACILITY NUMBER: 376629269
VISIT DATE: 04/25/2023
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This facility provides Incidental Medical Services – IMS.  LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records.   For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417.  The following information regarding ADA was provided:  US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication:  Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm. “And document your 809 - 809D if there are any deficiencies.

No deficiencies cited.

A Large Family Child Care Home license may be issued upon final file review. LPA Gloria Gonzalez interpreted and explained inspection report to Licensee, Licensee stated she understood.

An exit interview was conducted with Licensee, Heidi Martin.  The licensee was provided a copy of their report and appeal rights (LIC 9058). 

LPA provided notice of site visit, (LIC9213) and observed it being posted at the facility.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Gloria Gonzalez
LICENSING EVALUATOR SIGNATURE:

DATE: 04/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/25/2023
LIC809 (FAS) - (06/04)
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