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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 525408546
Report Date: 03/21/2025
Date Signed: 03/21/2025 08:50:57 AM

Document Has Been Signed on 03/21/2025 08:50 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:JIMENEZ, CINDY FAMILY CHILD CARE HOMEFACILITY NUMBER:
525408546
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 1DATE:
03/21/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:20 AM
MET WITH:Cindy JimenezTIME VISIT/
INSPECTION COMPLETED:
09:00 AM
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On 3/21/25 at 8:20am Licensing Program Analyst (LPA) conducted a case management and met with applicant Cindy Jimenez. LPA Bianca Mendez met with applicant to determine that applicant had completed the corrections during the prelicensing inspection.


During the inspection applicant had secured a 5ft mesh fencing around the in ground pool, there was a life ring, there was 12 ft rescue pole available and pool alarm available. Gate is self latching and locked. In ground pool did not have any water inside the pool. It was determined the corrections were completed. LPA is granting license effective 3/21/25.

Exit interview was conducted with applicant with Cindy Jimenez
SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Bianca Mendez
LICENSING EVALUATOR SIGNATURE: DATE: 03/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/21/2025
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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