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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198005381
Report Date: 01/18/2023
Date Signed: 01/18/2023 03:06:44 PM

Document Has Been Signed on 01/18/2023 03:06 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:SAINZ FAMILY CHILD CAREFACILITY NUMBER:
198005381
ADMINISTRATOR:SAINZ, MARTINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 641-9040
CITY:PICO RIVERASTATE: CAZIP CODE:
90660
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 8DATE:
01/18/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
02:35 PM
MET WITH:Licensee, Martina Sainz TIME COMPLETED:
03:15 PM
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Licensing Program Analyst (LPA) Roxana Lopez conducted an unannounced poc (plan of correction) inspection to insured that the Type A deficiencies cited on 1/6/2023 have been cleared. LPA met with Martina Sainz, licensee who guided analysts on a tour of the facility. There were 8 children present during this inspection. The following was observed:

- The report and notice of site visit issued on 1/6/2023 was posted in the entryway..
- LIC 9224 Acknowledgment of Receipt of Licensing Reports was signed and place in children's file.
- LPA observed children sleeping in appropriate sleeping arrangements.

LPA advised the licensee how to access forms, regulations and quarterly updates on the Child Care Licensing Website at: www.ccld.ca.gov

LPA cleared deficiency on this date and LPA issued POC clearance letter during the visit.

At this time, the licensee is in compliance with California Code of Regulations Title 22. Therefore, no deficiencies are being cited.

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 Licensee, Martina Sainz.
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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Roxana Lopez
LICENSING EVALUATOR SIGNATURE: DATE: 01/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/18/2023
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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