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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376630713
Report Date: 04/01/2026
Date Signed: 04/01/2026 01:35:28 PM

Document Has Been Signed on 04/01/2026 01:35 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
SAN DIEGO CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:DOMINIQUE ALEXIS, MARIE FANETTE FCCFACILITY NUMBER:
376630713
ADMINISTRATOR/
DIRECTOR:		MARIE FANETTE DOMINIQUE ALFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 373-3906
CITY:SAN DIEGOSTATE: CAZIP CODE:
92102
CAPACITY: 14TOTAL ENROLLED CHILDREN: 9CENSUS: 0DATE:
04/01/2026
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:00 PM
MET WITH:Marie Fanette Dominque AlexisTIME VISIT/
INSPECTION COMPLETED:
02:00 PM
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On 04/01/2026 at 12:00 p.m., Licensing Program Analyst (LPA) Victoria Felix conducted an announced change of location inspection with the licensee, Marie Fanette Dominque Alexis. LPA was granted entry after presenting her badge, identifying herself, and explaining the purpose of the visit. LPA requested the licensee’s identification card for verification. The one-story three-bedroom, one-bathroom home was toured and inspected to ensure it provides a safe environment for the care and supervision of children. Hours of operation stated on application and verified with licensee Sunday to Saturday from 5 a.m. to 10 p.m.. During inspection, there were no children or adults present. LPA interpreted during inspection and the following report in Spanish, and applicant stated she understood. Licensee stated she has nine children in care and listed on her roster.

Licensee will use the following rooms for child care: living room, kitchen, bathroom #1 and patio. Off-limit areas include bedrooms #1, #2, and #3, and garage which are made inaccessible through the use of doorknob covers. Licensee has sufficient toys and equipment available for children who will enroll in the program. Outdoor activities will take place in the fenced patio or at a nearby park. The licensee understands that children must always be under direct supervision while at the park.

First Aid and CPR expire on 9/2027 and preventative health practices course was completed on 7/2017. Licensee completed Mandated Reporter Training on 3/2026. Staff immunization requirements per SB792 were met.

Licensee has a fire extinguisher, carbon monoxide detector, and smoke detector that meet requirements and are operational. All hazardous items are latched, locked, and secured out of children’s reach. There are no bodies of water on the property. The licensee stated that there are no weapons in the home. Licensee states that they have sufficient financial resources to sustain the license.

NAME OF LICENSING PROGRAM MANAGER: Rajani Goudreau
NAME OF LICENSING PROGRAM ANALYST: Victoria Felix
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/01/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/01/2026
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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
SAN DIEGO CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: DOMINIQUE ALEXIS, MARIE FANETTE FCC
FACILITY NUMBER: 376630713
VISIT DATE: 04/01/2026
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Because the licensee rents/leases the home, proof of landlord notification is required. The LPA observed the Property Owner/Landlord Notification form (LIC 9151) that the licensee confirms was provided to the property owner/landlord. The licensee obtained a signed Property Owner/Landlord Consent form (LIC 9149).

Licensee was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.

LPA reviewed with licensee the LIC 311D, Forms/Records to Keep in your Family Child Care Home, children’s forms/records, facility forms/records, and information to be posted. Entrance Checklist was provided to the licensee. The new provider packet was reviewed with the licensee including information on ratios and capacity, child abuse reporting, children’s records, immunizations, adults living or working in the home, car seat laws, shaken baby syndrome, SIDS, effects of lead poisoning, and the YMCA Resource Center. The licensee was reminded that corporal punishment, smoking, walkers, exersaucers, jumpers, and bouncy seats are prohibited in day care. All equipment must be used only as intended by the manufacturer.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22- 02-CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. 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: https://www.ada.gov/resources/child-care-centers/.

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-andresources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for and removing any recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant products.

NAME OF LICENSING PROGRAM MANAGER: Rajani Goudreau
NAME OF LICENSING PROGRAM ANALYST: Victoria Felix
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/01/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/01/2026
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
SAN DIEGO CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: DOMINIQUE ALEXIS, MARIE FANETTE FCC
FACILITY NUMBER: 376630713
VISIT DATE: 04/01/2026
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Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters, and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/communitycare-licensing/subscribe and select the Child Care option to receive email communication.

On this date, 04/01/2026, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility address. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

LPA discussed and provided licensee with the following information: Child Care Advocates - email address childcareadvocatesprogram@dss.ca.gov. For common questions or questions regarding licensing requirements to contact the Child Care Licensing duty line at 619-767-2248.

If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

No corrections are needed. A license for 14 children may be issued upon final file review.

Licensee agreed to comply with all regulations and laws governing family child-care homes.

Exit interview conducted and report was reviewed with the licensee Marie Fanette Dominque Alexis

NAME OF LICENSING PROGRAM MANAGER: Rajani Goudreau
NAME OF LICENSING PROGRAM ANALYST: Victoria Felix
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/01/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/01/2026
LIC809 (FAS) - (06/04)
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