293624596-8-17-2023-03-CC-MGAO-CUSNG2-20230817102624

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 293624596
Report Date: 08/17/2023
Date Signed: 08/17/2023 10:26:36 AM

Document Has Been Signed on 08/17/2023 10:26 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME:	MOLINA, GIOVANNA		FACILITY NUMBER:	293624596
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 0	DATE:	08/17/2023
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	09:20 AM
MET WITH:	Giovanna Molina		TIME COMPLETED:	10:35 AM

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At 9:20am on 8/17/2023, Program Analyst (LPA) Matthew Gallo met with Licensee Giovanna Molina to conduct a Change of Capacity inspection. The Licensee is requesting an increase from 8 to 14 children. Today's census did not include any children in care. The facility's hours of operation are: Monday - Thursday 8:30am - 4:00pm, year round.

Off limits areas include: garage, half bathroom, sunroom, master bedroom, deck, and office. The Licensee acknowledged that children may never enter these off-limit areas. LPA observed the required postings, a working phone, 2A10BC fire extinguisher, and functioning smoke and carbon monoxide detectors. There are no bodies of water on the property and all hazardous items and chemicals are inaccessible to children. Stairs in the home are properly fenced. Overall, LPA observed the home to be clean, safe, sanitary, and in good repair with appropriate toys for children. In the areas that were evaluated during today's inspection, the facility is in compliance.

The licensee has been APPROVED to operate as a Large Family Child Care Home with a maximum capacity (when there is an assistant present) of 12 children with no more than four infants OR a capacity of 14 children no more than three Infants; one child must be in Transitional Kindergarten/Elementary School and one child must be at least six years old. If there is not an assistant present, the facility must revert to a Small Family Child Care Home license.

LPA reviewed the report with the Licensee and a copy was provided. Notice of Site was posted and must remain for 30 days.

SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Matthew Gallo
LICENSING EVALUATOR SIGNATURE:	DATE: 08/17/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2023

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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