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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 115407930
Report Date: 03/28/2024
Date Signed: 03/28/2024 08:25:43 AM

Document Has Been Signed on 03/28/2024 08:25 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CHICO CC RO, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME:RAYGOZA, JESSICA FAMILY CHILD CARE HOMEFACILITY NUMBER:
115407930
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 1DATE:
03/28/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:05 AM
MET WITH:Jessica Raygoza - Licensee TIME COMPLETED:
08:35 AM
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On 03/28/2024 at 8:05am, Licensing Program Analyst (LPA) Sydney Sims conducted an unannounced inspection and met with the licensee Jessica Raygoza. On 02/29/24 the licensee received a type A citation for not having a fence around an in ground pool in the Licensee's back yard. During today’s inspection, LPA observed the pool mesh fencing was five feet in all areas. The mesh fence does not obscure the pool from view. The gate used to enter the pool is not locked, swings away from the pool and self-closes as required. The licensee agrees to maintain the fence in good repair and Licensee will keep the fence in place whenever licensed care is being provided.

No deficiencies were cited during today's visit.

All licensing reports are public information and must be made available upon request for at least three years.

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

Exit interview was conducted and report was reviewed with Licensee Jessica Raygoza.
SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Sydney Sims
LICENSING EVALUATOR SIGNATURE: DATE: 03/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/28/2024
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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