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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 173009822
Report Date: 05/26/2021
Date Signed: 11/12/2021 03:10:24 PM

Document Has Been Signed on 11/12/2021 03:10 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, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928
FACILITY NAME:VALDOVINOS, MARIA G. FCCHFACILITY NUMBER:
173009822
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 14CENSUS: 6DATE:
05/26/2021
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
03:20 PM
MET WITH:Maria ValdovinosTIME COMPLETED:
03:50 PM
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Licensing Program Analyst (LPA) Leticia Rosales-Meza conducted a Face-time video conference Tele-Inspection Case Management with Martha Ramos, Licensee in response to an increase capacity application received by the Department on 2/26/21. The licensee is requesting a capacity of 14. Due to COVID-19, the Department has suspended all field operations, and the Licensee has agreed to meet with LPA via video conference. On 4/30/21, the Lake County Fire Marshal granted the facility a fire clearance to operate at a capacity of 14. A review of staff records on 5/26/21 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. There are currently two adults living in the home.

During the Tele-Inspection, the licensee provided a virtual tour of the facility’s on limits areas and backyard. The day care space is the living room, dining room, and hallway bathroom. The first floor, kitchen and all the bedrooms are "off limits" to the day children, and were made inaccessible by secured gates and key locked doors. The facility’s operating hours are 5:00 AM to 6:30 PM, Monday - Friday. The floor plan submitted by the licensee was reviewed and verified. Electrical outlets are covered and drapery cords are not accessible. The children's bathroom is free of toxins. There is a working telephone in the home. Items which could pose a danger to children (detergents, cleaning compounds, and medications) were stored out of the reach of children. There is a working smoke detector, carbon monoxide detector and fire extinguisher in the home. The licensee has a current roster of children in care and has conducted an emergency drill within the past six months. The licensee stated there are no firearms and/or other dangerous weapons in the home, and none were observed during today's Tele-Inspection. The children use the backyard as the outdoor play area and it is fully fenced. There are no bodies of water on the property. Pediatric CPR and Pediatric First Aid cards expire on 4/2023 for Licensee, and assistant. All licensing reports are public information and must be made available upon request for at least three years.
SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Leticia Rosales
LICENSING EVALUATOR SIGNATURE: DATE: 05/26/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/26/2021
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928
FACILITY NAME: VALDOVINOS, MARIA G. FCCH
FACILITY NUMBER: 173009822
VISIT DATE: 05/26/2021
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The Licensee's signature was not recorded on this Facility Evaluation Report (LIC 809 & LIC 809-C), however, the Licensee was provided with a copy of this report; and the Licensee's proof of Read Receipt is on file. LPA also mailed a copy of this report to the Licensee.


There were no Title 22 deficiencies cited during today's inspection.


The increase capacity to 14, as a Large Family Child Care Home is granted as of today, 5/26/21.
SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Leticia Rosales
LICENSING EVALUATOR SIGNATURE:

DATE: 05/27/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/27/2021
LIC809 (FAS) - (06/04)
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