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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 573620617
Report Date: 10/09/2020
Date Signed: 10/12/2020 12:42:47 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME:SANCHEZ, MARIAFACILITY NUMBER:
573620617
ADMINISTRATOR:SANCHEZ, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 302-7056
CITY:WINTERSSTATE: CAZIP CODE:
95694
CAPACITY:14CENSUS: 0DATE:
10/09/2020
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Maria SanchezTIME COMPLETED:
04:00 PM
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Due to current COVID-19 State of Emergency, Licensing Program Analyst (LPA) Amy Silva conducted a case management tele-inspection with Licensee, Maria Sanchez via Facetime. Today’s visit is a subsequent visit regarding the garage fire that occurred after hours at the facility on February 17th, 2020. The purpose of the visit is to ensure all necessary repairs were made to the garage. Licensee requested to change the garage from "off-limit" status to "on-limit" status. The garage was inspected, and determined to be in compliance with Title 22 regulations. LPA asked Licensee to provide LPA with a tour of her home. The areas of the home that were toured include; the backyard, all bedrooms, hallway bathroom, living room, laundry room, kitchen and garage. Licensee stated the garage has been insulated and is ready to be utilized. A functioning smoke and carbon monoxide detector were observed at 3:20 pm and a 3A10BC fire extinguisher was observed in the kitchen of the home.

As of today, October 9, 2020, LPA Silva has approved the garage to become "on-limits" and will change the license to reflect the change that was made.

Notice of Site and a copy of this report was provided via email.
SUPERVISOR'S NAME: Maria MayorgaTELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Amy SilvaTELEPHONE: (916) 926-9100
LICENSING EVALUATOR SIGNATURE:

DATE: 10/12/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2020
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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