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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494475
Report Date: 11/18/2022
Date Signed: 11/18/2022 12:06:48 PM

Document Has Been Signed on 11/18/2022 12:06 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:MARTINEZ FAMILY CHILD CAREFACILITY NUMBER:
197494475
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 7CENSUS: 2DATE:
11/18/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Grecia MartinezTIME COMPLETED:
11:30 AM
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On 11/18/2022, Licensing Program Analyst (LPA) Lillian Casillas conducted an announced Licensee Initiated Case Management Inspection for an Increase in Capacity. LPA met with Licensee, Grecia Martinez, who guided LPA on a tour of the inside and outside of the family child care home. LPA observed 1 assistant (cleared and associated) and 2 children in care. Hours of operation are Monday through Friday, 24 hours/day.

Facility is currently licensed for a small family child care home and is applying to increase capacity for a large family child care home. The age range for children in care is 0 months to 9 years old.

This is a single family home with 4 bedrooms, 2 bathrooms, living room, kitchen, dining room, laundry room, front yard, backyard, 1 detached recreation room, and 1 ADU. Childcare areas are: living room, dining room, bathroom 1, backyard, and recreation room. Off-limits areas are: bedroom 1, bedroom 2, bedroom 3, bedroom 4, bathroom 2, laundry room, front yard, and ADU. .

Indoor


LPA entered the property through the a gate that leads to the front yard. LPA entered the home through the front entrance door. Upon entering, LPA observed the parent board secured to the wall. In the dining room, LPA observed 1 dining table with 5 chairs. Licensee stated older children eat on the table and younger children eat on high chairs. Licensee stated the facility provides snacks and meals. In the living room, LPA observed 2 couches, age-appropriate toys and learning materials, and 1 TV secured to the wall. Licensee stated the living room is the primary child care area. In the kitchen, LPA observed child safety latches on all lower cabinet doors. In bathroom 1, LPA observed 1 toilet, 1 sink, 1 shower/tub, and 1 closet where cleaning supplies are stored. LPA observed a child safety latch on the closet door and a child safety latch on the cabinet underneath the sink.

Indoor Off-Limits
LPA observed a child safety latch on the door to the laundry room. LPA observed child safety knobs on all bedroom doors. Bathroom 2 is inaccessible as it is located within bedroom 4. [CONTINUE ON PAGE 2]
SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Lillian J Casillas
LICENSING EVALUATOR SIGNATURE: DATE: 11/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/18/2022
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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: MARTINEZ FAMILY CHILD CARE
FACILITY NUMBER: 197494475
VISIT DATE: 11/18/2022
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Indoor Off-Limits
LPA observed a child safety latch on the door to the laundry room. LPA observed child safety knobs on all bedroom doors. Bathroom 2 is inaccessible as it is located within bedroom 4.

Outdoor
LPA observed a fully-enclosed backyard with age-appropriate children's toys and play equipment. The backyard includes a grassy area and shade. LPA observed cameras in the backyard. In the recreation room, LPA observed 1 2A10:BC fire extinguisher, age-appropriate children's toys and learning materials, 1 refrigerator, and 1 sink. The recreation room also includes a bathroom with 1 toilet and 1 sink.

Outdoor Off-Limits
LPA observed a fully-enclosed front yard, which Licensee stated is off-limits. Licensee stated the detached ADU will remain locked during hours of operation. LPA observed the ADU is used for storage. Licensee stated that the ADU could be rented in the future and Licensee agreed to ensure tenants have a criminal record clearance. LPA observed two small dogs behind a gate to the side of the backyard. LPA observed current vaccination records. Licensee stated children do not interact with the dogs.

LPA advised Licensee to connect with the local Resource & Referral agency, Child Care Resource Center for help with admissions agreements, parent handbooks, and referrals. Phone: (818) 717-1000, Email: RREveryone@ccrca.org, Website: http://www.ccrca.org

Criminal Record Statement
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, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

[CONTINUE ON PAGE 3]

SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Lillian J Casillas
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2022
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: MARTINEZ FAMILY CHILD CARE
FACILITY NUMBER: 197494475
VISIT DATE: 11/18/2022
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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: http://www.ada.gov/childqanda.htm

Safe Sleep


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. LPA also informed Applicant of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Family Child Care Homes
LPA reviewed with Licensee the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted.

Subscribe to CCLD important information


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 platform. To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

Exit Interview


Exit interview conducted and report was reviewed with Licensee, Grecia Martinez. No corrections needed. Licensure will be granted upon approval by Licensing Program Manager, Maureen Neal.
SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Lillian J Casillas
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2022
LIC809 (FAS) - (06/04)
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