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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 061374085
Report Date: 07/23/2024
Date Signed: 08/02/2024 04:19:50 PM

Document Has Been Signed on 08/02/2024 04:19 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:SALCEDO DAY CAREFACILITY NUMBER:
061374085
ADMINISTRATOR/
DIRECTOR:		SALCEDO, EVELIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 458-2995
CITY:COLUSASTATE: CAZIP CODE:
95932
CAPACITY: 12TOTAL ENROLLED CHILDREN: 7CENSUS: 7DATE:
07/23/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:15 AM
MET WITH:Evelia SalcedoTIME VISIT/
INSPECTION COMPLETED:
10:15 AM
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On 7/23/204 at 9:15am, Licensing Program Analyst (LPA) Laura Chavez conducted a case management inspection with Licensee Evelia Salcedo in response to the Confirmation of Removal dated May 21, 2023. The Confirmation of Removal signed and dated on 7/23/2024 indicates Jorge D. Rodriguez was removed from the home sometime between 2021 - 2022. Based on evidence obtained during today's inspection, LPA has verified the individual is not present, employed, or residing at the facility. The licensee agrees to notify parents/guardians of children in care that this individual has been removed from the home by providing them with the Addendum to Notification of Parents' Rights (LIC995B). The licensee was reminded that civil penalties and/or disciplinary action including suspension of her license could result if Jorge D. Rodriguez is found to be living in the home prior to the individual receiving a criminal record exemption.

An exit interview was conducted and the report was reviewed with licensee Evelia Salcedo.



Notice of Site Visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. All licensing reports are public information and must be made available upon request. Verification of removal is complete.

Notice of Site Visit shall be posted for 30 days from today's visit
SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Laura Chavez
LICENSING EVALUATOR SIGNATURE: DATE: 07/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/23/2024
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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