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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493010001
Report Date: 06/09/2022
Date Signed: 06/09/2022 05:15:24 PM

Document Has Been Signed on 06/09/2022 05:15 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, 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: 7DATE:
06/09/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Margaret "Victoria" Lino-MartinezTIME COMPLETED:
05:30 PM
NARRATIVE
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Licensing Program Analysts (LPAs) Amy Strother and Sebastian Phouthavong arrived to the facility unannounced on 06/09/22 at 12:30pm and met with Licensee Victoria Lino-Martinez (L1). Upon entering the facility, LPA Strother observed 5 children, Child 1 - Child 5 (C1-C5) in the living room area and 1 child, Child 6 (C6) with L1 on the changing table in the hallway. Just after arriving to the facility C1 was picked up and went home. L1 requested that LPAs have a seat on the couch while she got the children their lunch. LPA Strother requested to know the ages of the children in care. L1 pointed to the space on the couch next to LPA Strother stating "That is (name), Child 7 (C7) and they are under 2 years old." LPA looked to the space L1 pointed to and observed a pile of multiple blankets to the right. LPA pulled the blankets back and observed an infant asleep, laying on their back. LPA asked L1 if there was a pack and play available for C7. L1 stated that the pack and plays are in the other room and that she just placed C7 there because LPA Strother called from outside and said she was coming in. LPA requested that L1 move C7 to the pack and play, to which L1 complied. L1 placed C7 in the pack and play in the on-limits bedroom.

LPA requested and received the facility roster from L1. L1 provided LPA with the roster. Upon review of the roster, LPA observed that 4 of the children in care are under the age of 2, L1 was operating above the ratio and capacity requirements. C4-C7 are under age two. C1-C2 are above age 2 and under 6 and C3 is 6 years of age. The maximum capacity of the facility is 6 children, no more than 3 infants or 4 infants only or maximum 8 children, no more than 2 infants, 1 child in kindergarten or elementary school and 1 child at least age 6. When LPA's arrived L1 was over capacity by 2 infants, when C1 went home, L1 was over capacity by 1 infant.

LPA discussed and reviewed 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.

Continue on LIC809-C

SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Amy Strother
LICENSING EVALUATOR SIGNATURE: DATE: 06/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/09/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		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 FCCH
FACILITY NUMBER: 493010001
VISIT DATE: 06/09/2022
NARRATIVE
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LPAs reviewed the capacity and ratio requirements of a family child care home, providing a handout for L1. L1 stated that she now clearly understand the maximum number of children for whom care can be provided, the limitations on the number of infants (birth to age 2) that may be cared for, and when two of the children in care must be school aged.

The following violation of the California Code of Regulations, Title 22; Division 12, were observed: see LIC 809D. Appeal Rights were provided.

LPA Strother informed licensee that this report dated 06/09/22 documents two Type A citations which shall be posted for 30 consecutive days as there are immediate risks to the health, safety, or personal rights of children in care.

Also, LPA Strother informed the licensee to provide a copy of this licensing report dated 06/09/22 that documents any Type A citations to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the licensee, Victoria Lino-Martinez.

SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Amy Strother
LICENSING EVALUATOR SIGNATURE:

DATE: 06/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2022
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 06/09/2022 05:15 PM - It Cannot Be Edited


Created By: Amy Strother On 06/09/2022 at 01:51 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: LINO-MARTINEZ, MARGARET FCCH
FACILITY NUMBER: 493010001

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/09/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/10/2022
Section Cited
CCR
102425(i)

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102425 Infant Safe Sleep (i) If an infant falls asleep before being placed in a crib or play yard, the provider shall move the infant to a crib or play yard as soon as possible.


This requirement was not met as evidenced by:
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L1 stated that she will create a routine for infant nap time, read stories to the infant, place infant in the pack and play prior to falling asleep and then pat the infant gently if crying to reassure the infant and continue to do so until a new sleep routine is established and the infant can fall asleep in the pack and play.
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Based on observation and interview, an infant (C7) was sleeping on the couch in the living room when LPAs arrived to the facility, which poses an immediate health and safety or personal rights risk to the child in care.
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Type A
06/10/2022
Section Cited
CCR102416.5(a)

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Staffing Ratio and Capacity - The capacity specified on the license shall be the maximum number of children for whom care can be provided.

This requirement was not met as evidenced by:
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L1 stated that she will need to terminate care of a least two infants in order to meet the ratio and capacity requirements and will call the families tonight, 06/09/22 to inform them that she is no longer able to provide care. L1 signed a copy of the ratio and capacity requirement stating that she understands them and will submit an updated roster as record of the date the children left to LPA Strother's email: amy.strother@dss.ca.gov
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 On 06/09/22 at 12:30pm LPAs observed seven children in care (C1-C7), C4-C7 are infants. L1 was operationing beyond the maximim capacity requirements which poses an immediate health and safety risk to the children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Alexis Hollon
LICENSING EVALUATOR NAME:Amy Strother
LICENSING EVALUATOR SIGNATURE:
DATE: 06/09/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/09/2022


LIC809 (FAS) - (06/04)
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