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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566208643
Report Date: 08/04/2022
Date Signed: 08/04/2022 10:17:43 AM

Document Has Been Signed on 08/04/2022 10:17 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, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:MARTINEZ FAMILY CHILD CAREFACILITY NUMBER:
566208643
ADMINISTRATOR:LEONILA MARTINEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 486-7462
CITY:OXNARDSTATE: CAZIP CODE:
93033
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: DATE:
08/04/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:38 AM
MET WITH:Leonila MartinezTIME COMPLETED:
10:30 AM
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On August 4, 2022 at 9:38 AM, Licensing Program Analyst (LPA) Laura Villanueva made an unannounced Case Management-Other inspection. The purpose of the visit is to serve, Solomon Martinez with a First Amended Accusation documentation. No one was present at the home. LPA was unable to serve First Amended Accusation.

Exit interview was not conducted with Licensee, Leonila Martinez due to her not being present. Notice of Site Visit and Appeal rights were left at front door. Copy of this licensing report was left at front door entrance of the facility, will be mailed certified and sent via email address on file to the licensee. Any further communication should be directed to our Department Legal Division.
SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Laura Villanueva
LICENSING EVALUATOR SIGNATURE: DATE: 08/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/04/2022
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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