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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 376100043
Report Date: 05/17/2023
Date Signed: 07/11/2023 12:59:31 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/10/2023 and conducted by Evaluator Selina Siao
COMPLAINT CONTROL NUMBER: 51-CC-20230510125355
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:14CENSUS: 12DATE:
05/17/2023
UNANNOUNCEDTIME BEGAN:
09:55 AM
MET WITH:Jason MartinsTIME COMPLETED:
12:15 PM
ALLEGATION(S):
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Facility did not have a roaster of the children in care on 05/10/2023
INVESTIGATION FINDINGS:
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On 05/17/2023 at 9:55am, Licensing Program Analyst (LPA), Selina Siao and Investigators T. Smith and G. Sun conducted an unannounced inspection to investigate the above allegation. Upon arrival, there were 12 children including 4 infants and no school age in care supervised by licensee and his wife /helper Luani Chagas. Appropriate ratio was observed during today's inspection.

During today's inspection, interview was conducted with the licensee regarding the above allegation. Licensee denied the detective asking him for the facility roster on 05/10/2023. Licensee had an updated roster during today's inspection. The detector was contacted today by phone and it was confirmed that he asked the licensee for the roster on 05/10/2023 and was told that he did not have a roster. Based on preponderance for evidence the above allegation is substantiated. See LIC9099D for type B citation issue.
Notice of Site Visit was posted and it shall remain posted for 30 days. Failure to keep it posted could result of in civil penalty of $100. Appeal rights were provided to licensee.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Selina Siao
LICENSING EVALUATOR SIGNATURE:

DATE: 07/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
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Control Number 51-CC-20230510125355
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: MARTINS, JASON FAMILY CHILD CARE
FACILITY NUMBER: 376100043
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/17/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/17/2023
Section Cited
CCR
102417(g)(8)
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Operation of a Family Child Care Home
Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841. This requirement is not met as evidence by:
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During today's inspection, the licensee had a roster and provided a copy of the roster to the department today.
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On 05/10/23, a detective had asked the licensee for the facility roster. The licensee did not have a roster available for the detective on that day. This poses a potential health and safety risk to clients in care
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Selina Siao
LICENSING EVALUATOR SIGNATURE:

DATE: 07/11/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2023
LIC9099 (FAS) - (06/04)
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