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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 525407971
Report Date: 02/25/2022
Date Signed: 02/25/2022 12:13:19 PM


Document Has Been Signed on 02/25/2022 12:13 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:RUBIO, FARRON FAMILY CHILD CARE HOMEFACILITY NUMBER:
525407971
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 2DATE:
02/25/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Farron RubioTIME COMPLETED:
09:00 AM
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A Case Management inspection was conducted by Licensing Program Analyst, Wisehart who met with the licensee Farron Rubio, who applied for a capacity increase. The local fire authority approved the capacity increase on 2/17/22 for a capacity of 14. The facilities operating hours are Tue - Fri 6:30 am - 5:30 pm and Mon 6:30 am - 12:30 pm.

The LPA toured the facilities indoor and outdoor. The play area; living room, dining nook and bathroom are the accessible indoor areas. The inaccessible areas are the kitchen, bedroom and laundry room which were made inaccessible via gates and door knob covers. The licensee was supervising 2 children at the time of the visit. The LPA printed and reviewed the ratio's for a large license and the licensee acknowledged she understood the ratio requirements. The LPA reviewed the Provider Information Notices 21-18 (June 29, 2021) and 21-29 (Nov 23, 2021) regarding COVID Guidance and Face Covering Requirements for Child Care Providers. The LPA also provided a copy of the 2/23/22 current County Mask Guidance. The facility has an operational smoke detector and carbon monoxide detector and fire extinguisher is rated at least the 2A10BC.



Based on the space/accommodations available at this facility and the fire marshal granting approval, the capacity increase request is granted. LPA will process this capacity increase and mail an updated license to reflect this capacity change to 14 children. An exit interview was conducted with Licensee.

Notice of Site Visit was given to licensee to post for 30 days.
SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Carrie WisehartTELEPHONE: (530) 895-5824
LICENSING EVALUATOR SIGNATURE:
DATE: 02/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/25/2022
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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