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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 065407293
Report Date: 10/23/2019
Date Signed: 10/31/2019 01:39:49 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:BUGARIN, MARIA FAMILY CHILD CARE HOMEFACILITY NUMBER:
065407293
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 0DATE:
10/23/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:40 PM
MET WITH:Maria Bugarin TIME COMPLETED:
01:50 PM
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LPA Laura Chavez conducted a case management inspection to the facility in response to an application submitted by the licensee requesting an increase in capacity. The requested capacity is 14. An approved fire safety inspection was received on 10/22/2019. The licensee is the property owner. The licensee operates 7 days a week, 24 hours a day. The licensee understands that 24 hour care to one child at one time is not allowed. Four adults currently reside in the home. The floor and yard plan were reviewed. The master bedroom is off-limits to children by means of a lock. Sharps, cleaning supplies & chemicals, and medications are stored out of the reach of the children. Poisons are locked in the garage. The fireplace located in the living-room has been professionally disconnected. There is a working smoke detector, carbon monoxide detector and fire extinguisher, rated at least 2A10BC, in the home. The licensee's CPR/First Aid expire 2/2020. This report was discussed with the licensee. All licensing reports are public information and must be made available upon request for at least three years.

Notice of Site Visit shall be posted for 30 days from today's visit.

The facility is in substantial compliance with Title 22 regulations. The increase in capacity is thereby granted.
SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Laura ChavezTELEPHONE: (530) 895-5914
LICENSING EVALUATOR SIGNATURE:

DATE: 10/23/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2019
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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