<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393622540
Report Date: 12/12/2022
Date Signed: 12/12/2022 02:08:17 PM


Document Has Been Signed on 12/12/2022 02:08 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
SACRAMENTO SOUTH, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833



FACILITY NAME:ANGUIANO, FABIOLAFACILITY NUMBER:
393622540
ADMINISTRATOR:ANGUIANO, FABIOLAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 808-4668
CITY:STOCKTONSTATE: CAZIP CODE:
95212
CAPACITY:14CENSUS: 6DATE:
12/12/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Fabiola AnguianoTIME COMPLETED:
02:30 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 12/12/22, Licensing Program Analyst (LPA) Mariya Melnichuk conducted a Case Management visit to verify that weapons were no longer stored in the facility. LPA met with Licensee, Fabiola Anguiano to inspect the home.There were six children present at the time of inspection. LPA verified that all adults working and living in the home have fingerprint clearance.

LPA inspected the home and confirmed that weapons are no longer stored in the safe and are removed from the facility.

Exit interview conducted and report was reviewed with the licensee. A notice of site visit was provided and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.



In the areas that were evaluated, no deficiencies were cited during today’s inspection.

SUPERVISOR'S NAME: Chayntel HunterTELEPHONE: (916) 917-8620
LICENSING EVALUATOR NAME: Mariya MelnichukTELEPHONE: (916) 917-9273
LICENSING EVALUATOR SIGNATURE:
DATE: 12/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/12/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1