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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073409080
Report Date: 10/14/2020
Date Signed: 01/12/2022 08:13:00 AM

Document Has Been Signed on 01/12/2022 08:13 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, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:MARINAKIS, AMYFACILITY NUMBER:
073409080
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
10/14/2020
TYPE OF VISIT:Case Management - OtherANNOUNCEDTIME BEGAN:
06:03 PM
MET WITH:Amy MarinakisTIME COMPLETED:
07:26 PM
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On October 14, 2020 at 6:03PM, Licensing Program Analyst (LPA) Catherine Fernandes conducted an announced Case Management Inspection with Licensee Amy Marinakis regarding an increase in capacity via FaceTime. Residing in the home is the Licensee and her finger print cleared husband. No children were present during the inspection. The home was virtually toured with the Licensee to conduct a health and safety inspection. Due to COVID-19 LPA focused mainly on the physical plant of the home and a pre-licensing/change of location Inspection was conducted on July 14, 2020. Operating hours will be 7:00am to 6:00pm, Monday through Friday.
The home is a single story house that consists of three bedrooms and two bathrooms. The OFF LIMIT AREAS are the master bedroom and bathroom and the garage which will be inaccessible by gate, closed and/or locked doors and visual supervision. The ON LIMIT AREAS are the living room, the kitchen/dining room, the fenced in backyard, the two bedrooms on the right side of the hallway and the bathroom. The ISOLATION AREA will be in the first bedroom.
The home has a fully charged 2A10BC fire extinguisher in the kitchen and pull down fire alarm on the wall between the kitchen and living room. A working smoke detector in the hallway and a carbon monoxide detector in the entryway of the home, a working telephone, and First Aid Kit. The Licensee's CPR and First Aid certificate is current and expires on March 2022. Per Licensee, there are no firearms in the home.
The Licensee was reminded of the responsibility as a mandated reporter and has provided proof of the required mandated reporter training for child care providers, which has been completed on 3/5/20.
On 10/14/20, a fire clearance was granted to facility #073409080 by Rodeo-Hercules Fire Department. All documents have been reviewed for the increase of capacity application. The Licensee was reminded that an assistant is needed with a large family child care home license, and whenever an assistant is not present, the licensee will comply with the capacity requirements for a small family child care home.

Report Continues on 809C.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Catherine Fernandes
LICENSING EVALUATOR SIGNATURE: DATE: 10/14/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/14/2020
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: MARINAKIS, AMY
FACILITY NUMBER: 073409080
VISIT DATE: 10/14/2020
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Licensee is reminded that ALL assistants, volunteers, frequent visitors, or adults living in the home, that are 18 years of age or older must be fingerprint cleared and associated to this facility prior to being in the presence of children in care or an immediate civil penalty will be assessed from $100 to $3000 per person, per incident. All forms can be downloaded at www.ccld.ca.gov .

As of 10/14/20, this home is recommended for an increase of capacity.

There are no deficiencies cited today.
The report will remain on file for three years.
An exit interview was conducted with Licensee.
Report will be mailed and emailed.




SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Catherine Fernandes
LICENSING EVALUATOR SIGNATURE:

DATE: 10/14/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2020
LIC809 (FAS) - (06/04)
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