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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 283009917
Report Date: 02/23/2023
Date Signed: 02/23/2023 12:31:41 PM

Document Has Been Signed on 02/23/2023 12:31 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, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:NARVAEZ, GABRIELA FCCHFACILITY NUMBER:
283009917
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 5DATE:
02/23/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Gaby NarvaezTIME COMPLETED:
12:45 PM
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Licensing Program Analyst (LPA) Glenn Ouye met with licensee Gaby Narvaez to conduct a capacity increase case management visit. The capacity increase application was received on February 6, 2023.

The facility has functioning combination smoke and carbon monoxide detectors and two fire extinguishers rated at least 2A10BC. The pull station is installed near the front door.

The capacity regulations were discussed with the licensee.

The facility is approved as a large family child care home effective today, February 23, 2023.
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Glenn Ouye
LICENSING EVALUATOR SIGNATURE: DATE: 02/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/23/2023
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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