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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 483003170
Report Date: 10/26/2022
Date Signed: 10/26/2022 02:30:38 PM


Document Has Been Signed on 10/26/2022 02:30 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, 520 COHASSET RD., SUITE 170
CHICO, CA 95926



FACILITY NAME:RAMIREZ, ALISA FAMILY CHILD CARE HOMEFACILITY NUMBER:
483003170
ADMINISTRATOR:RAMIREZ, ALISAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 952-6366
CITY:DIXONSTATE: CAZIP CODE:
95620
CAPACITY:14CENSUS: 12DATE:
10/26/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Alisa RamirezTIME COMPLETED:
02:35 PM
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On 10/26/2022 at 1:00pm a Required-1 Year inspection was made to the facility by Licensing Program Analyst (LPA), Laura Chavez. At 1:10pm the home was toured inside and outside. The licensee and assistant were supervising 12 children, and operating within the licensed capacity and ratio requirements. The facility’s operating hours are Monday-Friday: 6:30am-5:30pm Monday–Friday. The floor plan submitted by the licensee was reviewed. The off-limits areas of the home are the four bedrooms, office, and were made inaccessible by locks, and doorknob covers. The children use the front and back yard as the outdoor play areas. The backyard is not fully fenced, the licensee agrees that constant visual supervision is required while children are in the front yard. There is a in ground pool in the back yard. The pool is fully fenced with a wrought iron fence.

Five children's records were reviewed at 1:55pm. One staff record was reviewed at 1:35pm.

There are currently three adults living in the home. The Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.
Report continued: See LIC809-C
SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Laura ChavezTELEPHONE: (530) 895-5914
LICENSING EVALUATOR SIGNATURE:
DATE: 10/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/26/2022
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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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: RAMIREZ, ALISA FAMILY CHILD CARE HOME
FACILITY NUMBER: 483003170
VISIT DATE: 10/26/2022
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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

There were no deficiencies cited during today’s inspection.



Exit interview conducted and report was reviewed with Licensee Alisa Ramirez.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Notice of Site Visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Laura ChavezTELEPHONE: (530) 895-5914
LICENSING EVALUATOR SIGNATURE:

DATE: 10/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2022
LIC809 (FAS) - (06/04)
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