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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020846
Report Date: 03/28/2024
Date Signed: 03/28/2024 04:11:41 PM

Document Has Been Signed on 03/28/2024 04:11 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:MARTINEZ FAMILY CHILD CAREFACILITY NUMBER:
198020846
ADMINISTRATOR:MARTINEZ, CHRISTINE MARIEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 251-3169
CITY:ALTADENASTATE: CAZIP CODE:
91001
CAPACITY: 14TOTAL ENROLLED CHILDREN: 13CENSUS: 11DATE:
03/28/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Christine MartinezTIME COMPLETED:
04:20 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
On March 28, 2024, at 1:00 pm Licensing Program Analyst (LPA) Carolyn Tuba conducted an unannounced Case Management Deficiency inspection. A COVID risk assessment was conducted. LPA met with Licensee, Christine Martinez. LPA took a census of 11 children with 2 adult staff in care.

During previous visits conducted on November 29, 2023, and January 10, 2024, LPA observed two (2) Propane Commercial Heaters that were on the outside deck of where children have access during play and activity time. LPA also observed children were napping and eating outside on the deck. LPA advised Licensee that propane heaters pose a danger and that part of the care including napping and meal times for children require they be conducted in the home. Licensee stated that napping and eating will be done in the converted daycare/classroom of the home located right off the backyard. LPA was also informed during previous visits that there were additional adults living in the home that had criminal clearance and were associated to the license, however were not reported to the department that they were living in the home now. LPA consulted with Licensee that any changes need to be reported to the Department by completing an updated application. During today’s visit LPA received an updated LIC 279 Application for a Family Child Care Home (FCCH) with the additional adults’ names added. LPA did observe during today’s visit that two (2) Propane Commercial Heaters have been removed off the deck and put away and that napping, and mealtimes are being conducted inside the daycare/classroom located inside the home.

LPA informed Licensee that any advertising for example flyers, social media, banners, or websites and so forth require the facility number of the Family Child Care. LPA informed Licensee that the website that was previously up to the public did not display the facility number. Licensee stated that the website has been taken down, LPA confirmed. Licensee stated that she will add the License number in the future should they have a website again. A technical violation has been issued.

Page 1 of 2
SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Carolyn Tuba
LICENSING EVALUATOR SIGNATURE: DATE: 03/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/28/2024
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 4
Document Has Been Signed on 03/28/2024 04:11 PM - It Cannot Be Edited


Created By: Carolyn Tuba On 03/28/2024 at 02:39 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: MARTINEZ FAMILY CHILD CARE
FACILITY NUMBER: 198020846

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/28/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/28/2024
Section Cited
CCR
102352(f)(1)

1
2
3
4
5
6
7
"Family Day Care" or "Family Child Care" means regularly provided care, protection and supervision of children, in the care giver's own home, for periods of less than 24 hours per day, while the parents or authorized representatives are away......
1
2
3
4
5
6
7
Licensee will conduct care in the home by napping children and meal times inside the classroom/daycare room that is located inside the house.
8
9
10
11
12
13
14
This requirement was not met as evidence by: Based on observation, the children were napping and eating outside on the outside deck. This poses a potential health and safety risk to children in care.

8
9
10
11
12
13
14
Type B
03/28/2024
Section Cited
CCR412216.2(a)(2)

1
2
3
4
5
6
7
The licensee shall report the following information the Department by telephone or fax within the Department's next business day and during normal working hours (8am to 5pm). Any change in household composition including adults moving in or out of the home and anyone

1
2
3
4
5
6
7
Licensee will provide LPA an updated LIC279 application adding adults that currently live in the home.
8
9
10
11
12
13
14
living in the home who reaches his or her 18th birthday. This requirement was not met as evidence by: Based on record review tat additonal adults and children were currently living in the home. This poses a potential health and safety risk to children in care.
8
9
10
11
12
13
14
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Ana Chico
LICENSING EVALUATOR NAME:Carolyn Tuba
LICENSING EVALUATOR SIGNATURE:
DATE: 03/28/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/28/2024


LIC809 (FAS) - (06/04)
Page: 2 of 4
Document Has Been Signed on 03/28/2024 04:11 PM - It Cannot Be Edited


Created By: Carolyn Tuba On 03/28/2024 at 02:40 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: MARTINEZ FAMILY CHILD CARE
FACILITY NUMBER: 198020846

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/28/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/28/2024
Section Cited
CCR
102423(a)(2)

1
2
3
4
5
6
7
Personal Rights: Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee... to receive safe, healthful, and comfortable accommodations To receive safe, healthful, and comfortable accommodations, furnishings, and equipment.
1
2
3
4
5
6
7
Licensee will remove the propane heaters by POC date and submit proof to LPA.
8
9
10
11
12
13
14
This requirement was not met as evidence by: Based on observation, the facility has 2 outdoor propane heating lamps in the outside deck accessible to children in care. This poses an immediate health and safety risk to children in care.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Ana Chico
LICENSING EVALUATOR NAME:Carolyn Tuba
LICENSING EVALUATOR SIGNATURE:
DATE: 03/28/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/28/2024


LIC809 (FAS) - (06/04)
Page: 3 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: MARTINEZ FAMILY CHILD CARE
FACILITY NUMBER: 198020846
VISIT DATE: 03/28/2024
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
26
27
28
29
30
31
32
During the course of the visit, LPA issued Proof of Corrections (POCs) for previous citations of toileting 102423(a)(4) and 102359(b) parents are aware that facility operates as a Family Child Care Home (FCCH). LPA was provided a new facility sketch and a bathroom inside the home is open to children to utilize if the main bathroom is unavailable. LPA inspected the new bathroom for safety. LPA was provided a letter that was given and signed by each parent showing they had received it, as well as a new Admission Agreement that is given to parents during enrollment which has Martinez Family Care (Canon Trail) printed on the form including the address of where care is provided. LPA has consulted with Licensee, and she understands that Village Playgarden and Martinez Family Care (Canon Trail) will operate separately and accurately represents itself.

The following deficiency listed on the attached LIC 809 (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiency that are being cited need to be cleared to protect the children’s health & safety.

Type A - A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled children for the next 12 months (1 year). The Acknowledgement form must be maintained in each child’s file immediately upon receipt from parent. Licensee was provided with a copy of the parent Acknowledgement of Receipt of Licensing Reports Form during this visit.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Licensee, Christine Martinez.

Page 2 of 2
SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Carolyn Tuba
LICENSING EVALUATOR SIGNATURE:

DATE: 03/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2024
LIC809 (FAS) - (06/04)
Page: 4 of 4