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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343623831
Report Date: 07/18/2023
Date Signed: 07/18/2023 10:25:33 AM

Document Has Been Signed on 07/18/2023 10:25 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:HINOJOSA, NORMAFACILITY NUMBER:
343623831
ADMINISTRATOR:NORMA HINOJOSAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 694-4506
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95610
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 6DATE:
07/18/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Norma Hinojosa, LicenseeTIME COMPLETED:
10:35 AM
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On July 18, 2023, Licensing Program Analyst (LPA) Eduardo Barragan conducted an unannounced visit at the facility. LPA Barragan met with Licensee Norma Hinojosa.

The purpose of this visit was to change a room from off-limits to on-limits. LPA toured the day-care inside and out. LPA inspected bedroom three to ensure that it meet title 22 regulations prior to changing the room to on-limits. LPA Barragan obtained an updated facility sketch (LIC 999A).

LPA and Applicant conducted a tour of the on-limits areas inside and out for health and safety hazards.
The home is a one story home with a partly fenced front yard, 3 bedrooms, 2 bathrooms, kitchen, living room, laundry room, office, fenced backyard, 2 sheds, and guest house in the backyard. As of today the off-limit areas were updated: The off-limits areas are the master bedroom, master bathroom, bedroom 2, laundry room, office, 3 sheds in the backyard, guest house in the backyard, and fish pond. Applicant was notified that she would need to contact the department before making any on-limits areas to off-limits or vice versa.

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 Norma Hinojosa, Licensee.

SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Eduardo Barragan
LICENSING EVALUATOR SIGNATURE: DATE: 07/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/18/2023
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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