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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 214005621
Report Date: 09/22/2022
Date Signed: 09/22/2022 08:45:07 AM

Document Has Been Signed on 09/22/2022 08:45 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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:MARIN, REYNA LILYFACILITY NUMBER:
214005621
ADMINISTRATOR:MARIN, REYNA LILYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 847-9607
CITY:SAN RAFAELSTATE: CAZIP CODE:
94903
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 2DATE:
09/22/2022
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
08:25 AM
MET WITH:Reyna Lily MarinTIME COMPLETED:
09:00 AM
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On 9/22/2022, Licensing Program Analyst (LPA), Hanson Leong, made an announced case management visit to the Reyna Lily Marin facility. Reyna Lily Marin, the licensee, has requested a departmental visit because she wants to use an additional room for her day-care. The LPA was granted entry by the licensee. The LPA explained the purpose of the visit to the licensee. Guardian, the department's system for conducting background checks, has confirmed that all the individuals listed on the facility’s roster have been granted permission to work or be present in a childcare facility. The LPA observed the licensee supervising one infant and one preschool child. Children's capacity and ratio requirements were observed to be in compliance.

The LPA and the licensee carried out a thorough inspection of the napping room to look for any potential health and safety concerns. The area that is set aside for napping is well kept and clean  Every item of furniture, toy, and piece of equipment has been inspected to ensure that it is appropriate for the age range and in good shape. There are resting mats and cribs for the children to nap on while they are there, and there is also storage room for the children's own belongings. There are both smoke and carbon monoxide detectors installed in the room that is used as a napping area.

The LPA will provide approval for the napping room to become a component of the licensed day care facility. The napping room will take affect on 9/22/2022.

A copy of this report, and the “Notice of Site Visit,” were given to the licensee. A “Notice of Site Visit” must remain posted for 30 days.Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

An exit interview was conducted, and the report was reviewed with the Licensee, Reyna Lily Marin
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
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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