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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 525407971
Report Date: 06/15/2022
Date Signed: 06/15/2022 09:49:23 AM

Document Has Been Signed on 06/15/2022 09:49 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, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME:RUBIO, FARRON FAMILY CHILD CARE HOMEFACILITY NUMBER:
525407971
ADMINISTRATOR:RUBIO, FARRONFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 591-2922
CITY:LOS MOLINOSSTATE: CAZIP CODE:
96055
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 7DATE:
06/15/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
08:35 AM
MET WITH:Farron RubioTIME COMPLETED:
09:20 AM
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The Licensing Program Analyst (LPA) Wisehart conducted a Case Management visit at the request of the licensee who installed an above ground pool. The LPA met with the licensee, Farron Rubio and toured the facility both inside and outside at 8:40 am.

The LPA observed the above ground pool in the backyard. The outdoor pool was partially fenced with a 5 feet fence and a self-closing, self latching gate that swings away from the pool. The latch is not more than 6" from the top of the gate. The windows that egress on the north side of the home where the dog run is, only has a fence height of 4' 2" made of white lattice. Therefore, the licensee will be required to either put window locks and alarms on the bedroom windows or increase the height of the fence on the dog run side and replace with a fence that does not obstruct the pool view. The bathroom window which is small but egresses into the pool area will have a lock and alarm added, per licensee and a waiver will be requested.

No deficiencies were cited during today's visit. A Notice of Site Visit must be posted for 30 days.
SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Carrie Wisehart
LICENSING EVALUATOR SIGNATURE: DATE: 06/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/15/2022
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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