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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 283009989
Report Date: 03/29/2022
Date Signed: 03/29/2022 05:36:29 PM


Document Has Been Signed on 03/29/2022 05:36 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
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405



FACILITY NAME:ACEVES, MARIA FCCHFACILITY NUMBER:
283009989
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 7DATE:
03/29/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
04:40 PM
MET WITH:Maria AcevesTIME COMPLETED:
05:45 PM
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A case management inspection was conducted to the facility by Licensing Program (LPA) Leticia Rosales-Meza in response to an increase capacity application received by the Department on 02/23/22. The licensee is requesting a capacity of 14. A review of staff records indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. The facility is toured inside and outside. The facility’s operating hours are 5:00 AM to 8:00 PM, Monday - Saturday.

The floor plan submitted by the licensee was reviewed and verified. The off-limits areas of the home are the three bedrooms and kitchen, and were made inaccessible by means of door knob slip covers, and a secured gate between the kitchen and living room. The home was observed to be clean and orderly, and was at a comfortable indoor temperature of 70 degrees Fahrenheit. Electrical outlets are covered and drapery cords are not accessible. The children's bathroom is free of toxins. There is a working telephone in the home. Items which could pose a danger to children (detergents, cleaning compounds, and medications) were stored out of the reach of children. There is a working smoke detector, carbon monoxide detector and fire extinguisher in the home. The licensee has a current roster of children in care and has conducted an emergency drill within the past six months. There are no firearms in the home, and none were observed during the inspection. The children use the side carport area of the mobile home as the outdoor play. The children are also taken to a nearby neighborhood park for outdoor play. There are no bodies of water on the property. All licensing reports are public information and must be made available upon request for at least three years. Pediatric CPR and Pediatric First Aid cards expire 05/2022 for Licensee, and for assistant Pediatric CPR and Pediatric First Aid cards expire on 08/2022. The Napa City Fire Marshall inspected and granted the fire clearance on 03/10/2022.

The increase capacity to 14, as a Large Family Child Care Home is granted as of today, 3/29/22.

There were no violations of Title 22 Regulations cited during today's visit.

NOTICE OF SITE VISIT SHALL BE POSTED FOR 30 DAYS FROM TODAY'S VISIT
SUPERVISOR'S NAME: Alexis HollonTELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Leticia RosalesTELEPHONE: (707) 588-5061
LICENSING EVALUATOR SIGNATURE:
DATE: 03/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/29/2022
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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