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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343623831
Report Date: 04/21/2022
Date Signed: 04/21/2022 12:52:53 PM

Document Has Been Signed on 04/21/2022 12:52 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, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:HINOJOSA, NORMAFACILITY NUMBER:
343623831
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 5CENSUS: 3DATE:
04/21/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
11:55 AM
MET WITH:Norma HinojosaTIME COMPLETED:
01:00 PM
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Licensing Program Analyst (LPA) Fabiola Diaz met with the Licensee, Norma Hinojosa for the purpose of a case management inspection. Inspection took place on 4/21/2022. During today's inspection, there were 3 children present in care.

Today's inspection was requested to change the backyard from "off-limits" status to "on-limits" status and to inspect the fish pond's fencing. The backyard and pond fencing was inspected and determined to be in compliance with Title 22 regulations. The pond's fence was over 5 ft tall, and the gate self-closed and self-latched. The backyard contains safe toys and play equipment. LPA advised licensee to check toys, pond's fencing, and backyard constantly to ensure they are in operable and safe conditions meeting Title 22; Licensee stated she will. Licensee requested that the backyard area behind the guest house to be off-limits. Licensee provided LPA with an updated facility sketch.

As of today, 4/21/2022, LPA Diaz has approved the backyard to become "on-limits", except for the area behind the guest house. LPA will change the licence to reflect the change that was made today.

Notice of Site was provided and LPA advised the Licensee that she will be sent a new license to display in her home. No deficiencies were cited today.
SUPERVISORS NAME: Roxana Saravia
LICENSING EVALUATOR NAME: Fabiola Diaz
LICENSING EVALUATOR SIGNATURE: DATE: 04/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/21/2022
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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