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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 485408079
Report Date: 09/06/2024
Date Signed: 09/06/2024 09:13:28 AM

Document Has Been Signed on 09/06/2024 09:13 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, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:VALENZUELA, MIREYA FAMILY CHILD CARE HOMEFACILITY NUMBER:
485408079
ADMINISTRATOR/
DIRECTOR:
VALENZUELA, MIREYAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(707) 770-5671
CITY:VACAVILLESTATE: CAZIP CODE:
95687
CAPACITY: 14TOTAL ENROLLED CHILDREN: 11CENSUS: 10DATE:
09/06/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:30 AM
MET WITH:Mireya Valenzuela - LicenseeTIME VISIT/
INSPECTION COMPLETED:
09:30 AM
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
Licensing Program Analyst (LPA), Melchisedeck Augustin conducted an unannounced Case Management visit and met with Licensee (LS), Mireya Valenzuela, for the purpose of following up on an outstanding plan of correction that was due on 09/03/24. On 08/30/24, LS was cited a type B deficiency because LS's statement confirmed two children (C1-C2) under 24 months old slept on cots, could not climb out of a crib or play yard; and LS did not have a crib or play yards available for C1-C2 to take a nap.

During today's visit, LPA counted ten children in care which included C1. According to LS's statement, C2 was no longer enrolled in care and LS only had one child under 24 months old enrolled in care. LS furnished evidence of play yard that was enclosed with a mesh frame, the sleeping equipment's mattress was an exact fit and the mattress was covered with a fitted sheet. LS produced a written statement to explain C2 was no longer enrolled in care and thus, a second play yard was not needed. LPA cleared the deficiency related to California Code of Regulations (CCR) 102425(a) which indicated one crib or play yard for each infant who is unable to climb out of the crib or play yard, and a copy of the Letter of Deficiencies Citations Cleared was provided to LS.

Exit interview conducted and report was reviewed with the Licensee, Mireya Valenzuela. 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. There were no violation(s) of the California Code of Regulations, Title 22; Division 12, observed during today’s visit.
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Melchisedeck Augustin
LICENSING EVALUATOR SIGNATURE: DATE: 09/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/06/2024
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