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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 136610668
Report Date: 04/18/2024
Date Signed: 04/18/2024 12:54:40 PM

Document Has Been Signed on 04/18/2024 12:54 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
MISSION VALLEY, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:MARTINEZ, NOEMI FAMILY CHILD CAREFACILITY NUMBER:
136610668
ADMINISTRATOR/
DIRECTOR:		NOEMI MENDEZ MARTINEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(422) 258-4037
CITY:EL CENTROSTATE: CAZIP CODE:
92243
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 4DATE:
04/18/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:00 PM
MET WITH:Noemi Martinez, Applicant TIME VISIT/
INSPECTION COMPLETED:
01:10 PM
NARRATIVE
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On 04/18/2023 at 12:00 pm, Licensing Program Analyst (LPA), Michelle Hood conducted an unannounced Case Management Inspection and met with Applicant Noemi Martinez (Martinez). When LPA arrived she observed four children at the home. The applicant Martinez stated two children are from separates families. Martinez stated the other two are her grandchildren. The LPA reviewed five children's files.

On 03/25/2024, Martinez submitted a Family Child Care application to CCLD. Martinez understands continued operation pending licensure is a violation of law and could result in civil penalties of $200.00 per day.

LPA provided two letters which returned to CCLD by the United States Postal Services as undeliverable to the applicant.

An exit interview was conducted, and the report was reviewed with the applicant Noemi Martinez. The applicant was provided with a copy of their appeal rights (LIC 9058 03/22) and their signature on this form acknowledges receipt of these rights. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. See LIC 809D for a type B deficiency.
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Michelle Hood
LICENSING EVALUATOR SIGNATURE: DATE: 04/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/18/2024
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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Document Has Been Signed on 04/18/2024 12:54 PM - It Cannot Be Edited


Created By: Michelle Hood On 04/18/2024 at 11:45 AM
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
, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: MARTINEZ, NOEMI FAMILY CHILD CARE
FACILITY NUMBER: 136610668

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/18/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/20/2024
Section Cited
HSC
1596.80

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1596.80 Child day care facilities, licenses. No person, firm, partnership, association, or corporation shall operate, establish, manage, conduct, or maintain a child day care facility in this state without a current valid license, therefor as provided in this act. This requirement was not met by:

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The applicant stated she will write a declartion stating she understands she can only care for one other family until she is licensed by CCLD. The applicant will provide the LPA a schedule showing the times and days the children will attend separately at the facility.
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On 04/18/2024, the applicant admitted two of the children in care were from two separate families, and the other two children are her grandchildren. LPA reviewed the children's files.
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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.
SUPERVISOR'S NAME:Cynthia Gray
LICENSING EVALUATOR NAME:Michelle Hood
LICENSING EVALUATOR SIGNATURE:
DATE: 04/18/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/18/2024


LIC809 (FAS) - (06/04)
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