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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 173010115
Report Date: 02/13/2023
Date Signed: 02/13/2023 11:55:41 AM

Document Has Been Signed on 02/13/2023 11:55 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:CORDERO MARROQUIN, HERLINDA FCCHFACILITY NUMBER:
173010115
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 5DATE:
02/13/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Erlinda CorderoTIME COMPLETED:
12:00 PM
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Licensing Program Analyst (LPA) Glenn Ouye met with licensee, Herlinda Cordero to conduct a capacity increase inspection. She is going from a small FCCH to a large FCCH.

The large capacity worksheet was covered with the licensee. Her mother is her assistant.

The home has a functioning smoke and carbon monoxide detector and a fully charged 2A10BC fire extinguisher.

The capacity change to a large is effective today, February 13, 2023.
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Glenn Ouye
LICENSING EVALUATOR SIGNATURE: DATE: 02/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/13/2023
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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