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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 483005929
Report Date: 02/25/2022
Date Signed: 02/25/2022 01:58:57 PM

Document Has Been Signed on 02/25/2022 01:58 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, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:VUSD - FEDERAL TERRACE CDC - INFANT/TODDLERFACILITY NUMBER:
483005929
ADMINISTRATOR:TRUJILLO, MARISAFACILITY TYPE:
830
ADDRESS:415 DANIELS AVENUETELEPHONE:
(707) 556-8755
CITY:VALLEJOSTATE: CAZIP CODE:
94590
CAPACITY: 17TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
02/25/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Monique Garcia - Center DirectorTIME COMPLETED:
09:00 AM
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Licensing Program Analyst (LPA), Melchisedeck Augustin made a Case Management visit and met with Center Director, Monique Garcia (CD). During today's visit, there were no child(ren) in care and the facility was not setup to care for child(ren), and the classroom was being utilized as a storage area. CD claimed the facility had not been in operation since March 2020 and at this time, the facility wanted to pursue inactive status as the facility would not be in operation for the remainder 2022 year due to the COVID-19 pandemic. CD confirmed the facility intends to continue operation in the future, however; CD could not provide an exact date. Due to no children in care and LPA's observations of the facility not in operation, LPA did not conduct a Required Inspection. Department records indicates the facility fee are current until 02/22/2023. LPA provided and obtained a completed copy of the LIC 9211. The facility made a request to place the license on Inactive Status from 02/25/22 through 02/25/23, however; the facility's inactive status may only be placed on inactive status until 02/22/23.

CD understood that the facility may be placed on inactive status for up to 12 months and the inactive status may only be extended until the facility's anniversary date. CD also understood she may request the facility status be changed from inactive status to licensed status, however; the facility is subject to an inspection prior to being placed on licensed status. This report was reviewed and discussed with CD. 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.
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Melchisedeck Augustin
LICENSING EVALUATOR SIGNATURE: DATE: 02/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/25/2022
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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