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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 115406755
Report Date: 03/13/2024
Date Signed: 03/13/2024 02:12:06 PM

Document Has Been Signed on 03/13/2024 02:12 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:GONZALEZ, ERIKA FAMILY CHILD CARE HOMEFACILITY NUMBER:
115406755
ADMINISTRATOR:GONZALEZ, ERIKAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 586-9199
CITY:ORLANDSTATE: CAZIP CODE:
95963
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 12DATE:
03/13/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
01:50 PM
MET WITH:Erika GonzaleszTIME COMPLETED:
02:21 PM
NARRATIVE
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On 3/13/24 @ 1:50 pm Licensing Program Analyst (LPA Bianca Mendez conducted an unannounced case management inspection. An annual inspection was conducted on 3/6/24 which resulted in a citation for the assistant not having a livescan clearance available. A
LPA conducted a case management on 3/13/24 to clear licensee's citation for having uncleared adult at the facility. At 1:48pm, LPA observed a school bus drop off 3 children, when licensee had 8 children in care. LPA did not observe any other assistants. LPA observed a total of 11 children in care and licensee operating of out of ratio. During the visit licensee had parents picking up children to stay within ratio and LPA observed 7 children in care at 2:11pm

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and appeal rights were provided. This report was reviewed with the licensee, Erika Gonzalez
SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Bianca Mendez
LICENSING EVALUATOR SIGNATURE: DATE: 03/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/13/2024
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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Document Has Been Signed on 03/13/2024 02:12 PM - It Cannot Be Edited


Created By: Bianca Mendez On 03/13/2024 at 01:57 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: GONZALEZ, ERIKA FAMILY CHILD CARE HOME
FACILITY NUMBER: 115406755

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/13/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/13/2024
Section Cited
CCR
102416(a)(d(1)

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Staffing Ratio and Capacity
(a) The capacity specified on the license shall be the maximum number of children for whom care may be provided at any one time.(d) For a Large Family Child Care Home, the maximum number of children for whom care may be provided at any one time when there is an assistant provider in the home, including children under age 10 who reside at the licensee's home and the assistant provider's children under age 10, shall be either:
(1) Twelve children, no more than four of whom may be infants; or
This requirement was not met as evidence by:
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Licensee is in the process of hiring an assistant and called someone to assist to meet the ratio requirements and will submit a plan of correction to CCLD acknowleding that they understand the ratio requirements.
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Based on observation, the licensee did not comply with the section cited above which licensee had 11 children and no assistants present.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Megan Aviles
LICENSING EVALUATOR NAME:Bianca Mendez
LICENSING EVALUATOR SIGNATURE:
DATE: 03/13/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/13/2024


LIC809 (FAS) - (06/04)
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