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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 173010406
Report Date: 08/21/2024
Date Signed: 08/21/2024 02:02:39 PM

Document Has Been Signed on 08/21/2024 02:02 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
SANTA ROSA CC RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:GUZMAN DE MONTEJANO, MARISOL FCCHFACILITY NUMBER:
173010406
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 7CENSUS: 0DATE:
08/21/2024
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:35 PM
MET WITH:Marisol Guzman de MontejanoTIME VISIT/
INSPECTION COMPLETED:
02:05 PM
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A case management inspection was conducted to the facility by Licensing Program (LPA), Cindy Castro in response to an increase capacity application received by the Department on 08/01/24. The licensee is requesting a capacity of 14. A review of staff records indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. The facility is toured inside and outside. The facility’s operating hours are 12:00 AM to 11:58 PM, Monday - Friday. The floor plan submitted by the licensee was reviewed and verified. The day care areas will be the living room, kitchen, one bathroom, playroom/bedroom, patio and front yard. One bedroom and laundry room are "off limits" to the children and were made inaccessible by doorknob cover and child safety lock. The children use the front yard as the outdoor play area. The front yard is completely fenced. There were no pools or other bodies of water observed on premises. The home was observed to be clean and orderly and was at a comfortable indoor temperature. The children's bathroom is free of toxins. There is a working telephone in the home. Items which could pose a danger to children (detergents, cleaning compounds, and medications) were stored out of the reach of children. There is a working smoke detector, carbon monoxide detector and fire extinguisher in the home. There is a barricaded fire place in the living room. The licensee has a current roster of children in care and has conducted an emergency drill within the past six months. There are no firearms in the home, and none were observed during the inspection. Pediatric CPR and Pediatric First Aid cards expire 06/2026. The Santa Rosa Fire Marshall inspected and granted the fire clearance on 08/16/24. All licensing reports are public information and must be made available upon request for at least three years.

The increase capacity to 14, as a Large Family Child Care Home is granted as of today, 08/21/24.
SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Cindy Castro
LICENSING EVALUATOR SIGNATURE: DATE: 08/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/21/2024
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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