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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 525407639
Report Date: 02/18/2022
Date Signed: 02/18/2022 04:29:13 PM


Document Has Been Signed on 02/18/2022 04:29 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:GALVAN, MARIA FAMILY CHILD CARE HOMEFACILITY NUMBER:
525407639
ADMINISTRATOR:GALVAN, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 433-6622
CITY:CORNINGSTATE: CAZIP CODE:
96021
CAPACITY:14CENSUS: 11DATE:
02/18/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
12:20 PM
MET WITH:Maria GalvanTIME COMPLETED:
12:30 PM
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A case management Licensee initiated inspection was conducted by Licensing Program Analyst (LPA) Mendez in response to a new floor plan submitted by licensee. Licensee had added garage in floor plan and will be used as the playroom and the inside of the house will continue to be accessible to children. Main entrance will be at the house and children will continue to have access to bathroom in the main house. The floor plan was submitted by licensee and verified. A fire clearance for the playroom was granted on 1/31/2022. Electrical outlets were covered. The fire extinguisher is rated at least 2A-10 BC and located on the wall. Cleaning supplies are kept locked in a cabinet. There is a working smoke detector and carbon monoxide detector in the playroom. Clearance is granted for licensee to use playroom for children.
SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Bianca MendezTELEPHONE: (530) 895-4357
LICENSING EVALUATOR SIGNATURE:
DATE: 02/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/18/2022
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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