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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 515406330
Report Date: 09/05/2019
Date Signed: 09/06/2019 11:00:20 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:ALVARADO, MARIA FAMILY CHILD CARE HOMEFACILITY NUMBER:
515406330
ADMINISTRATOR:ALVARADO, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 673-2724
CITY:YUBA CITYSTATE: CAZIP CODE:
95993
CAPACITY:14CENSUS: 11DATE:
09/05/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Maria AlvaradoTIME COMPLETED:
10:15 AM
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Licensing Program Analyst (LPA) Laura Chavez conducted a case management visit to the home for the purpose of providing the licensee with a copy of the Civil Penalty assessed on 9/3/2019 for a repeat violation.

During today's visit, LPA toured the home. The licensee and two assistants were caring for two infants and nine preschool age children.

All licensing reports are public information and must be made available upon request for at least three years.

Notice of Site Visit shall be posted for 30 days from today's visit.
SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Laura ChavezTELEPHONE: (530) 895-5914
LICENSING EVALUATOR SIGNATURE:

DATE: 09/05/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/05/2019
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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