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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343623671
Report Date: 11/16/2023
Date Signed: 11/16/2023 09:41:50 AM

Document Has Been Signed on 11/16/2023 09:41 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:HUIZAR, MARIAFACILITY NUMBER:
343623671
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
11/16/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:Maria HuizarTIME COMPLETED:
10:00 AM
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Licensing Program Analyst (LPA) Christopher Bello arrived at approximately 8:30am and met with licensee Maria Huizar for an unannounced Case Management Licensee Initiated inspection. Today’s inspection regarded the backyard to the on-limits portion of her license. Also present was licensee’s two adult children and husband. LPA observed that the backyard was incompliance with Title 22 regulations and the Health and Safety Code. The off-limits areas in the home: All bedrooms, master bathroom and sideyard. Off-limits areas will remain inaccessible to children by closed doors and/or supervision.

No Title 22 Deficiencies observed in the areas that were evaluated. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee [or facility representative] Maria Huizar.
SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Christopher Bello
LICENSING EVALUATOR SIGNATURE: DATE: 11/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/16/2023
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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