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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 515408101
Report Date: 11/04/2025
Date Signed: 11/04/2025 01:48:18 PM

Document Has Been Signed on 11/04/2025 01:48 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:HEREDIA, LUZ FAMILY CHILD CARE HOMEFACILITY NUMBER:
515408101
ADMINISTRATOR/
DIRECTOR:		HEREDIA, LUZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 769-6870
CITY:YUBA CITYSTATE: CAZIP CODE:
95991
CAPACITY: 14TOTAL ENROLLED CHILDREN: 8CENSUS: 5DATE:
11/04/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:40 AM
MET WITH:Luz HerediaTIME VISIT/
INSPECTION COMPLETED:
01:55 PM
NARRATIVE
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An unannounced case management inspection was conducted today at 11:40am by Licensing Program Analyst (LPA), Laura Chavez. LPA met with licensee Luz Heredia. The inspection is made in response to the licensee self-reporting an Unusual Incident Report to the Department on 10/28/2025 involving the licensee leaving Child #1 (C1) alone in the car for approximately 20 minutes.

The licensee, Luz Heredia, reported the incident on the day it occurred, 10/28/2025, at 3:53pm stated, she had Child #1 (C1), Child#2 (C2), Child #3 (C3), Child #4 (C4), and Child #5 (C5) in her care when she was scheduled to leave to pick up children from school. The licensee said she usually leaves the children already in her care with her assistant (A1) while she picks up children from school. Licensee said C1 started to cry when they saw her leaving, and it was then that she decided to take C1 with her. The licensee said she buckled C1 in the car seat in the back of her vehicle, where C1 fell asleep. Licensee said the children she picked up from school were all taken directly to their homes and therefore thought she had no children left in her car. Licensee said she arrived back home at approximately 3:18pm, went inside, and started heating food. At approximately 3:40pm, the parent (P1) of C1, C2, C3, C4, and C5 arrived and asked where C1 was. The licensee said that was when she realized she had left C1 in the car.

NAME OF LICENSING PROGRAM MANAGER: Megan Aviles
NAME OF LICENSING PROGRAM ANALYST: Laura Chavez
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 11/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/04/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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Document Has Been Signed on 11/04/2025 01:48 PM - It Cannot Be Edited


Created By: Laura Chavez On 11/04/2025 at 11:55 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: HEREDIA, LUZ FAMILY CHILD CARE HOME
FACILITY NUMBER: 515408101

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/04/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/05/2025
Section Cited
CCR
1597.58(c)(2)

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The department shall assess an immediate civil penalty of five hundred dollars ($500) per violation...for any of the following serious violations (2) Absence of supervision, including, but not limited to, a child left unattended. This requirement was not met as
evidenced by:
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The licensee agrees to provide a written statement on how she will ensure maintaining continuous supervision to all children in care.

The plan of correction shall be submitted to CCLD on or before 11/5/2025.
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Based on the licensee's admission of leaving Child #1 (C1) alone in the car for approximately 20 minutes. An immediate civil penalty of $500 applies. This poses an immediate health and safety risk to children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Megan Aviles
NAME OF LICENSING PROGRAM MANAGER:
Laura Chavez
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 11/04/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/04/2025


LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME: HEREDIA, LUZ FAMILY CHILD CARE HOME
FACILITY NUMBER: 515408101
VISIT DATE: 11/04/2025
NARRATIVE
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During today’s inspection, the facility was toured, LPA observed the licensee and her assistant (A1) caring for 5 children.

Based on the information the licensee reported, of C1 being left alone in the car for approximately 20 minutes, the following deficiency, 1597.58(c)(2) is being cited on the LIC809-D.

LPA Laura Chavez informed licensee Luz Heredia that this report, dated 11/4/2025, documents 1 (one) Type A citation, which shall be posted for 30 consecutive days, as there is an immediate risk to the health, safety, or personal rights of children in care.

LPA Laura Chavez informed the licensee, Luz Heredia to provide a copy of this licensing report dated 11/4/2025 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

An exit interview was conducted, and the report was reviewed with the licensee, Luz Heredia. Appeal Rights were provided. 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.

NAME OF LICENSING PROGRAM MANAGER: Megan Aviles
NAME OF LICENSING PROGRAM ANALYST: Laura Chavez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2025
LIC809 (FAS) - (06/04)
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