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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376100043
Report Date: 07/21/2023
Date Signed: 07/21/2023 11:18:36 AM

Document Has Been Signed on 07/21/2023 11:18 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
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:MARTINS, JASON FAMILY CHILD CAREFACILITY NUMBER:
376100043
ADMINISTRATOR:JASON MARTINSFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(858) 705-4160
CITY:SAN DIEGOSTATE: CAZIP CODE:
92127
CAPACITY: 14TOTAL ENROLLED CHILDREN: 11CENSUS: 12DATE:
07/21/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
10:55 AM
MET WITH:Jason MartinsTIME COMPLETED:
11:25 AM
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 07/21/2023 at 10:55am, Licensing Program Analyst (LPA) Selina Siao conducted a plan of correction inspection to ensure that the facility is within compliance with all title 22 regulations. Present at the day care today is licensee, his wife Luani Martins and 9 day care children including 2 day care infants. Licensee's two daughters and his infant son is also present. Facility is within staffing ratio during today's inspection.

Licensee has conducted a fire drill with the children in care on 07/14/2023 and submitted a copy of the drill log to LPA. Licensee has also replaced the outlet cover in the living room area. Facility is within compliance during today's inspection.

Licensee will submit all the children's LIC9224 acknowledgment receipt of licensing report to LPA no later than Monday 07/24/2023.

No citation issue. Notice of site visit was provided and it must remain posted for 30 days.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Selina Siao
LICENSING EVALUATOR SIGNATURE: DATE: 07/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/21/2023
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