<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406216412
Report Date: 10/05/2023
Date Signed: 10/05/2023 06:11:39 PM

Document Has Been Signed on 10/05/2023 06:11 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, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:MADRIGAL FCC AKA TINY TOWN PRESCHOOLFACILITY NUMBER:
406216412
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 1DATE:
10/05/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
05:11 PM
MET WITH:Amanda Madrigal TIME COMPLETED:
06:20 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 10/05/23, at 5:11 PM, Licensing Program Analyst (LPA) Martina Jimenez conducted an unannounced Case Management inspection for a change of capacity. LPA met with Amanda Madrigal, Licensee of the FCCH and explained the purpose of the inspection.

LPA and Licensee together toured the an interior and exterior of the FCCH. LPA observed the FCCH's interior and exterior to be free of hazardous materials and/or toxins at the time of the visit, which would pose a danger to the children in care. LPA observed 1 child in care at the time of the inspection.

Licensee’s First Aid/ CPR certification which expires on 8/8/2024. LPA observed a regulation fire extinguisher which was serviced on 08/25/2023. LPA reviewed the Licensee’s Mandated Reporter Training certificate, which was completed on 08/31/2022.

On 09/15/23, the Licensee submitted documentation for a FCCH change of capacity. The Licensee is seeking to change the FCCH’s capacity from 8 (Small FCCH) to 14 (Large FCCH). The Atascadero City Fire Department granted a fire clearance following an inspection completed at FCCH on 9/27/2023.

The home meets Title 22 of CCR requirements for a Large Family Child Care license. The license is pending Managers Approval. LPA provided the Licensee a Notice of Site Visit (LIC 9213) to be posted.


THIS REPORT MUST BE FILED IN FACILITY FILE AND MADE AVAILABLE FOR PUBLIC REVIEW FOR 3 YEARS. LPA observed the "Notice of Site Visit" posted. FAILURE TO POST THE NOTICE OF SITE VISIT FOR 30 DAYS MAY RESULT IN A $100.00 CIVIL PENALTY.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Martina Jimenez
LICENSING EVALUATOR SIGNATURE: DATE: 10/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/05/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1