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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493010001
Report Date: 09/22/2022
Date Signed: 09/22/2022 09:09:04 AM

Document Has Been Signed on 09/22/2022 09:09 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
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:LINO-MARTINEZ, MARGARET FCCHFACILITY NUMBER:
493010001
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 2DATE:
09/22/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Victoria Lino-MartiniezTIME COMPLETED:
09:30 AM
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Licensing Program Analyst (LPA) Glenn Ouye met with the licensee Victoria Lino-Martinez to conduct a capacity increase. The approved fire clearance was received on 9/13/2022.
The facility has functioning smoke and carbon monoxide detectors and a fully charged fire extinguisher rated at least 2A10BC.

LPA observed that LPA Strother provided the licensee with a copy of the large FCCH ratio requirements. LPA Ouye and the licensee also discussed staff requirements.

A copy of the approved fire inspection was given to the licensee.

The facility is approved as a large FCCH effective today, September 22, 2022. An updated license with the capacity of 14 will be sent to the licensee.

No deficiencies cited during the visit.
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Glenn Ouye
LICENSING EVALUATOR SIGNATURE: DATE: 09/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/22/2022
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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