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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 515406371
Report Date: 08/10/2023
Date Signed: 08/10/2023 01:40:40 PM

Document Has Been Signed on 08/10/2023 01:40 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, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME:JUPINA, HILARY FAMILY CHILD CARE HOMEFACILITY NUMBER:
515406371
ADMINISTRATOR:JUPINA, HILARYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 617-5123
CITY:LIVE OAKSTATE: CAZIP CODE:
95953
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
08/10/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Hilary JupinaTIME COMPLETED:
01:45 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 8/10/2023 at 1:15pm, Licensing Program Analyst (LPA) Laura Chavez conducted a visit to the home for the purpose of conducting a Required-1 Year inspection. Upon arrival to the home licensee Hilary Jupina informed LPA that she was not caring for children at this time and requested to place her license in inactive status. During today's inspection the licensee completed and provided a Request for Inactive Child Care License Status (LIC9211).

All licensing reports are public information and must be made available upon request for at least three years.

Notice of Site Visit shall be posted for 30 days from today's visit.
SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Laura Chavez
LICENSING EVALUATOR SIGNATURE: DATE: 08/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/10/2023
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