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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 173010605
Report Date: 10/23/2024
Date Signed: 10/23/2024 10:37:26 AM

Document Has Been Signed on 10/23/2024 10:37 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
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:MOYA VILLALOBOS, MARIANA FCCHFACILITY NUMBER:
173010605
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 3DATE:
10/23/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Mariana Moya VillalobosTIME VISIT/
INSPECTION COMPLETED:
10:55 AM
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On 10/23/2024, Licensing Program Analyst, Sebastian Phouthavong has conducted Case Management Visit regarding Licensee requesting for an increase of capacity to the daycare. Today, LPA met with Licensee, Mariana Moya Villalobos. Prior to visit, Licensee received a Fire Safely Inspection conducted by the local Fire Department and LPA received an approved STD 850 for an increase of capacity to 14 daycare children on 10/02/2024. Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

During the inspection the home was toured inside and outside. The licensee and assistant were supervising 3 children and operating within the licensed capacity and ratio requirements. The facility’s operating hours are Monday – Friday, 6:45 AM – 6:00 PM. The floor plan submitted by the licensee was reviewed and verified. Licensee stated the facility plans to slowly increase her capacity for a day and will start with supervising 10 daycare children at one time.

Licensee reviewed that an assistant must be present when the capacity is over 8 daycare children. Also that Assistant Provider means a person at least 14 years of age who is primarily involved in caring for children during the hours that the home provides care. LPA provided the Capacity Requirements for a Large Family Child Care Home and regulation 102370 Criminal Record Clearance.

Licensee has met the requirements to increase her capacity and has been approved.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the Licensee, Mariana Moya Villalobos.

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

SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Sebastian Phouthavong
LICENSING EVALUATOR SIGNATURE: DATE: 10/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/23/2024
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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