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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 483009887
Report Date: 03/17/2023
Date Signed: 03/17/2023 01:11:29 PM

Document Has Been Signed on 03/17/2023 01:11 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
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:FONSECA, HILLARY FCCHFACILITY NUMBER:
483009887
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 4DATE:
03/17/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:40 PM
MET WITH:Hillary FonsecaTIME COMPLETED:
01:15 PM
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Licensing Program Analyst (LPA) Glenn Ouye met with licensee Hillary Fonseca to conduct a capacity increase as she is going from a small family child care home to a large. The application was received on January 23 2023. The fire clearance was approved on February 9, 2023. This fire clearance includes the garage for use. The licensee will child safety gates to keep the children within the garage. There are also smoke and carbon monoxide detectors in the garage. The fire inspector also required the exit sign above the garage door.

The home has a pull station at the rear of the home. The is a fully charged fire extinguisher mounted on the wall hear the garage door. There are functioning carbon monoxide detector and smoke detectors.

LPA discussed the child ratio requirements for a large FCCH with the licensee.

The facility is approved as a large effective today, March 17, 2023.
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Glenn Ouye
LICENSING EVALUATOR SIGNATURE: DATE: 03/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/17/2023
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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