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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 065407853
Report Date: 02/04/2021
Date Signed: 06/29/2021 03:34:10 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:SILVA, MARIA FAMILY CHILD CARE HOMEFACILITY NUMBER:
065407853
ADMINISTRATOR:SILVA, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 237-9632
CITY:COLUSASTATE: CAZIP CODE:
95932
CAPACITY:14CENSUS: 0DATE:
02/04/2021
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Maria SilvaTIME COMPLETED:
04:00 PM
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On 2/4/2020 at 2:00pm, Licensing Program Analyst (LPA) Laura Chavez conducted a prelicensing inspection in response to an application for a change of location, the requested capacity is 14. The inspection was conducted via tele-inspection due to the current State of Emergency caused by COVID-19. During today's tele-inspection LPA discussed and reviewed information from the COVID-19 Self-Assessment guide and posters. The licensee agrees to maintain COVID-19 posters posted as required. Days and hours of operation will be Monday-Sunday; 4:30am-11:30pm. The licensee understands that 24 hour care to one child at one time is not allowed. Two adults and one minor currently reside in the home. The licensee is the homeowner. A review of the Facility Personnel Report Summary made on 2/3/2021 indicate that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. During today’s tele-inspection the home and grounds were toured. The residence is a two-story home with five bedrooms and 2.5 bathrooms. The second floor is off-limits to children. A gate has been placed at the bottom of the stairs. The garage is currently off-limits to children. Electrical outlets were covered and cords to window coverings were not accessible. There is a working telephone. The sharp knives, cleaning supplies, medicines, are stored out of the reach of children. There are age appropriate toys available for the children. There is a working smoke detector, carbon monoxide detector and a fully charged fire extinguisher in the home. Notification of Parents Rights, Emergency Disaster Plan, with the Earthquake Preparedness Checklist shall be posted. The floor and yard plan were verified.
SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Laura ChavezTELEPHONE: (530) 895-5914
LICENSING EVALUATOR SIGNATURE:

DATE: 02/08/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/08/2021
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME: SILVA, MARIA FAMILY CHILD CARE HOME
FACILITY NUMBER: 065407853
VISIT DATE: 02/04/2021
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The licensee understands that any poison brought into the home shall be locked as required. The children will use the backyard as the outdoor play area. The backyard is completely fenced. There is no trampoline, pool, spa, pond, nor any other source of water accessible to the children, and none of these items are to be added without prior notification and approval of the licensing agency.

Any proposed changes to the physical plant, telephone number, or change of address shall be immediately reported to the Department.

Prior to licensing the home, the following shall be submitted:

1. Copy of an approved fire inspection.

2. Update facility sketch showing the garage as off limits to children. Note: The licensee
understands that an updated facility sketch and additional fire clearance is required prior
to allowing children to use the garage as a playroom.

3. Proof of plate cover installed over on/off switch that controls the fireplace.
SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Laura ChavezTELEPHONE: (530) 895-5914
LICENSING EVALUATOR SIGNATURE:

DATE: 02/04/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2021
LIC809 (FAS) - (06/04)
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