<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 065407489
Report Date: 01/10/2024
Date Signed: 01/10/2024 04:05:21 PM

Document Has Been Signed on 01/10/2024 04:05 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:MATA, CRISTINA FAMILY CHILD CARE HOMEFACILITY NUMBER:
065407489
ADMINISTRATOR:MATA, CRISTINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 870-2202
CITY:COLUSASTATE: CAZIP CODE:
95932
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
01/10/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Cristina MataTIME COMPLETED:
04:10 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On January 3, 2024, at 3:30pm, Licensing Program Analysts (LPAs) Laura Chavez and Elizabeth Friese conducted an unannounced case management inspection and met with Licensee Cristina Mata.

During today's inspection LPAs Chavez and Friese inspected the newly installed wrought iron fence which surrounds the in-ground pool and spa located in the backyard. The fence is 6' tall and constructed so that the fence does not obscure the pool from view. The bottom is no more than 2" from the ground and openings are no more than 4" wide. The gate swings away from the pool, self-closes and has a self-latching device located no more than six inches from the top of the gate.

The deficiency CCR 102417(g)(5)(A), initially cited during a visit on 11/16/2023, has been cleared.

A Notice of Site Visit was given. The Notice of Site Visit must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.00. All licensing reports are public information and must be made available upon request for at least three years.

Exit interview conducted and report was reviewed with Licensee Cristina Mata.

SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Laura Chavez
LICENSING EVALUATOR SIGNATURE: DATE: 01/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/10/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1