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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343624418
Report Date: 04/04/2023
Date Signed: 04/04/2023 11:59:09 AM

Document Has Been Signed on 04/04/2023 11:59 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:GORRICHATEGUI, BRUNAFACILITY NUMBER:
343624418
ADMINISTRATOR:BRUNA GORRICHATEGUIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 747-1921
CITY:SACRAMENTOSTATE: CAZIP CODE:
95827
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 13DATE:
04/04/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Bruna GorrichateguiTIME COMPLETED:
12:15 PM
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On Tuesday, April 4, 2023, Licensing Program Analyst (LPA) Amanda Sutter met with licensee Bruna Gorrichategui to conduct an unannounced Case Management inspection. On March 21, 2023, licensee submitted an application to change the garage an on limits area. LPA received an update Emergency Disaster Plan and LIC999. LPA received the update fire clearance, approving the use of the room, March 31, 2023. The fire clearance states that the change of use for the garage to a living space was approved by the Sacramento County Building department.

Upon arrival, LPA observed 13 children supervised by licensee, licensee's staff, and licensee's husband. LPA observed proper ratio being followed. All individuals subject to criminal background review have obtained a criminal record clearance.

A health and safety evaluation was conducted in all areas accessible to children. The home is two story. Off-limit areas include: master bedroom and master bathroom. Licensee acknowledged that children may never enter these off-limit areas. Licensee acknowledges that children residing in the home under the age of 10 years shall be included in capacity.

Effective today, licensee is approved to use the garage space.

In the areas that were evaluated, no deficiencies were observed at the time of the visit. Exit interview conducted with licensee Bruna Gorrichategui. Notice of site visit posted.
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Amanda Sutter
LICENSING EVALUATOR SIGNATURE: DATE: 04/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/04/2023
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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