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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
045407621
Report Date:
12/14/2020
Date Signed:
12/15/2020 01:38:39 PM
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY
FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office
,
520 COHASSET RD., SUITE 170
CHICO
,
CA
95926
FACILITY NAME:
BOLANOS GUTIERREZ, CRISTAL FAMILY CHILD CARE HOME
FACILITY NUMBER:
045407621
ADMINISTRATOR:
FACILITY TYPE:
810
ADDRESS:
TELEPHONE:
CITY:
STATE:
ZIP CODE:
CAPACITY:
8
CENSUS:
DATE:
12/14/2020
TYPE OF VISIT:
Case Management - Licensee Initiated
ANNOUNCED
TIME BEGAN:
12:00 PM
MET WITH:
TIME COMPLETED:
12:15 PM
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This licensee initiated this facility inspection to add an outdoor activity area to license. LPA met with licensee on this date and time via tele-inspection due to the current state of emergency regarding the COVID-19 outbreak.
The purpose of today's inspection is to utilize further areas of the outdoors of this facility for child care outdoor activities. This outdoor area is reached via steps that all have hand rails and area is gated and fully fenced in. All areas are adequately safe for children.
This outdoor area is adequate for children's activity space at this facility.
SUPERVISOR'S NAME:
Erin Virrueta
TELEPHONE:
(530) 895-4325
LICENSING EVALUATOR NAME:
David Wilson
TELEPHONE:
(530) 513-0993
LICENSING EVALUATOR SIGNATURE:
DATE:
12/14/2020
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
12/14/2020
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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