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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
515405673
Report Date:
05/17/2019
Date Signed:
05/17/2019 09:47:56 AM
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:
PUREWAL, RAJVINDER FAMILY CHILD CARE HOME
FACILITY NUMBER:
515405673
ADMINISTRATOR:
PUREWAL, RAJVINDER
FACILITY TYPE:
810
ADDRESS:
TELEPHONE:
(530) 755-1122
CITY:
YUBA CITY
STATE:
CA
ZIP CODE:
95993
CAPACITY:
14
CENSUS:
11
DATE:
05/17/2019
TYPE OF VISIT:
Case Management - Other
UNANNOUNCED
TIME BEGAN:
09:05 AM
MET WITH:
Rajvinder Purewal
TIME COMPLETED:
10:01 AM
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Licensing Program Analyst (LPA) Martinez conducted an unannounced visit to the home due to a new facility sketch being sent into the office. LPA Martinez conducted a tour of the home that is accessible and used by the licensee. The licensee has rented part of her home and made part of the home inaccessible to the tenants. The home appears safe and orderly at this time. Children from the day care do not have access to the home that is rented.
No citations were issued during today's visit and Notice of site visit must be posted for 30 days.
SUPERVISOR'S NAME:
Erin Virrueta
TELEPHONE:
(530) 895-4325
LICENSING EVALUATOR NAME:
Mikah Martinez
TELEPHONE:
(530) 895-4014
LICENSING EVALUATOR SIGNATURE:
DATE:
05/17/2019
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
05/17/2019
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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