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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343625500
Report Date: 03/18/2024
Date Signed: 03/18/2024 04:21:38 PM

Document Has Been Signed on 03/18/2024 04:21 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:VILLANUEVA, VIRGINIAFACILITY NUMBER:
343625500
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 4DATE:
03/18/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
02:52 PM
MET WITH:Villanueva, Virgina TIME COMPLETED:
04:20 PM
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On Monday, March 18th, 2024 at 2:52p.m., Licensing Program Analyst (LPA) Pa Dao Vang met with Licensee Virginia Villanueva to conduct an unannounced Change of Capacity Inspection. The Licensee is requesting an increase from 8 to 14 children. Today's census included 4 children, consisting of 3 preschool children and 3 infants. Licensee's husband, adult child, 1 child under ages 10 years old, and another child over ages of 10 years old was also present for the inspection. The facility will operate Monday thru Friday 6:00 AM- 5:00 PM, year-round. LPA confirmed that all adults residing and working in the home have a criminal record clearance through Community Care Licensing.

Off Limit Areas include: Bedroom #1, Bedroom #3, dining room, kitchen, gated grass area of the backyard, front yard, and garage. Licensee acknowledged that children may never enter these off-limit areas. LPA observed the required postings, a working phone, 2A-10-BC fire extinguisher, smoke alarm, and functioning smoke and carbon monoxide detectors. Licensee stated there are no weapons in the home, and LPA observed all toxic and hazardous items to be inaccessible to children. Overall, LPA observed the home to be clean, safe, sanitary, and in good repair with appropriate toys for children. In the areas that were evaluated during today's inspection, the facility is in compliance.

The Fire clearance was granted on 3/6/2024 prior to inspection.


The Licensee has been APPROVED today to operate as a Large Family Child Care Home with a maximum capacity (when there is an assistant present) of 12 children with no more than four infants OR a capacity of 14 children no more than three Infants; one child must be in Transitional Kindergarten/Elementary School and one child must be at least six years old. If there is not an assistant present, the facility must revert to a Small Family Child Care Home license.

Continue report on LIC809-C...

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Dao Vang
LICENSING EVALUATOR SIGNATURE: DATE: 03/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/18/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: VILLANUEVA, VIRGINIA
FACILITY NUMBER: 343625500
VISIT DATE: 03/18/2024
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Exit interview conducted and report was reviewed with Licensee Virginia Villanueva. A notice of site visit and must remain posted for 30 days. Appeal rights and copy of 102416.5 Staffing Ratio and Capacity regulations were also provided to Licensee. A copy of the LIC9150 is also provided to Licensee.
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Dao Vang
LICENSING EVALUATOR SIGNATURE:

DATE: 03/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2024
LIC809 (FAS) - (06/04)
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