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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 483010082
Report Date: 09/30/2022
Date Signed: 09/30/2022 10:07:24 AM

Document Has Been Signed on 09/30/2022 10:07 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:VALENCIA, BELYN FCCHFACILITY NUMBER:
483010082
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 5DATE:
09/30/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:25 AM
MET WITH:Licensee Belyn ValenciaTIME COMPLETED:
10:10 AM
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A case management inspection was conducted to the facility by Licensing Program (LPA) Elpidia Hernandez Torres in response to an increase capacity application received by the Department on 09/09/2022. 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 was toured inside and outside. The facility’s operating hours are 6:30 AM to 6:30 PM, Monday - Friday.

The floor plan submitted by the licensee was reviewed and verified. The off-limits areas of the home are the garage, and bedrooms number 1 and 2. They were made inaccessible by means of door knob slip covers and/or door locking mechanisms. The home was observed to be clean and orderly, and was at a comfortable indoor temperature. Electrical outlets are covered and drapery cords are not accessible. 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. 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. The children use the backyard as the outdoor play area and it is fully fenced. There are no bodies of water on the property. All licensing reports are public information and must be made available upon request for at least three years. Pediatric CPR and Pediatric First Aid cards expire 11/2022. The Fairfield Fire Department inspected and granted the fire clearance on 09/20/2022.

The increase capacity to 14, as a Large Family Child Care Home is granted as of today, 09/30/22.
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Elpidia Hernandez Torres
LICENSING EVALUATOR SIGNATURE: DATE: 09/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/30/2022
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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