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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 475407664
Report Date: 04/06/2023
Date Signed: 04/06/2023 02:42:43 PM

Document Has Been Signed on 04/06/2023 02:42 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
CHICO-DAY CARE, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME:LOPEZ, MELISA FAMILY CHILD CARE HOMEFACILITY NUMBER:
475407664
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 5CENSUS: 1DATE:
04/06/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Melisa Lopez, LicenseeTIME COMPLETED:
03:00 PM
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On 4/6/2023 at approximately 2:00pm, Licensing Program Analyst (LPA) N. Cunningham conducted a case management inspection with Licensee Melisa Lopez in response to the Confirmation of Removal dated January 28, 2023. The Confirmation of Removal signed 4/6/23 indicates Edwin Lopez was removed from the home on January 3, 2021. Based on evidence obtained during today inspection, LPA has verified the individual is not present, employed, or residing at the facility. The licensee provided Edwin Lopez's current address. The licensee was reminded that civil penalties and/or disciplinary action including suspension of her license could result if Mr. Lopez is found to be living in the home prior to the individual receiving a criminal record exemption.

All licensing reports are public information and must be made available upon request. At this time, there were no deficiencies noted of Title 22 Regulations. Appeal rights were provided. Verification of removal is complete.



Notice of Site Visit shall be posted for 30 days from today's visit.
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Nicolette Cunningham
LICENSING EVALUATOR SIGNATURE: DATE: 04/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/06/2023
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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