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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 065403662
Report Date: 11/17/2021
Date Signed: 11/17/2021 03:07:26 PM

Document Has Been Signed on 11/17/2021 03:07 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:MORENO, MARIA YESENIA FAMILY CHILD CARE HOMEFACILITY NUMBER:
065403662
ADMINISTRATOR:MORENO, MARIA YESENIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 619-9419
CITY:WILLIAMSSTATE: CAZIP CODE:
95987
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 7DATE:
11/17/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Maria Yesenia MorenoTIME COMPLETED:
03:10 PM
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On 11/17/2021 at 2:15pm Licensing Program Analyst (LPA) Laura Chavez conducted an unannounced case management inspection and met with licensee, Maria Yesenia Moreno. On 6/24/2021 the licensee reported a visit received on 6/23/2021 from Officer #1 of the Williams Police Department. Officer #1 notified the licensee of a Suspected Child Abuse Report received alleging that approximately 3 years ago Child #1 inappropriately touched Child #2 while in care. The incident of neglect/lack of care and supervision resulting in a child being inappropriately touched was investigated by Investigations Branch (IB) Investigator Jorge Martinez. Given the statements and interviews provided, IB Investigator Martinez determined there is insufficient evidence to substantiate the allegation for lack of care and supervision.

This report was reviewed and discussed with the licensee. 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 inspection.

There were no Title 22 deficiencies cited during today's inspection.
SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Laura Chavez
LICENSING EVALUATOR SIGNATURE: DATE: 11/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/17/2021
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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