<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073409174
Report Date: 11/04/2022
Date Signed: 11/04/2022 12:15:08 PM

Document Has Been Signed on 11/04/2022 12:15 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, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:TEJADA-MARTINEZ, CHRISTINA AND MARTINEZ, HAROLDFACILITY NUMBER:
073409174
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 6DATE:
11/04/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Cristina Tejada-Martinez and Harold MartinezTIME COMPLETED:
12:30 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Cherie Acosta conducted an unannounced case management/ increase in capacity inspection. LPA met with Licensee Cristina and Harold Martinez and toured the home. There were 4 preschool aged children and 2 infant in care. Licensee has an approved fire clearance dated 8/16/22.

The entire first floor, except the laundry room, is on limits to children. The laundry room and the entire second floor is off limits to children in care. The off limits area will be made inaccessible by use of gates, closed and/or locked doors and visual supervision The fenced backyard will be used for outdoor play. There are age appropriate toys in the home. There are no firearms in the home as stated by licensee. LPA did not observe any hazardous materials or toxins accessible to children today. The home is equipped with a working smoke detector and carbon monoxide detector. There is a working telephone in the home. The home has a fully charged 3A40BC fire extinguisher. The home has a gas fireplace that is not used during child care hours as stated by licensee.. Stairs are gated.

Cristina and Harold Martinez have current CPR/First Aid which expires 5/18/23. Cristina Martinez completed mandated reporter training 6/15/21. Harold Martinez completed mandated reporter training 6/16/21. Licensees are in compliance with required immunizations for child care providers.
An annual required inspection was also completed today. Files reviews were conducted on the annual required inspection.

The requested increase in capacity is approved effective today, 11/4/22.
Exit interview conducted with Harold Martinez.
Notice of Site Visit was provided and must be posted for 30 days.
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Cherie Acosta
LICENSING EVALUATOR SIGNATURE: DATE: 11/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/04/2022
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 1