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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493010153
Report Date: 04/29/2024
Date Signed: 04/29/2024 12:42:55 PM

Document Has Been Signed on 04/29/2024 12:42 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:GONZALEZ DE DIOS, MAURINA FCCHFACILITY NUMBER:
493010153
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 5DATE:
04/29/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:55 AM
MET WITH:Maurina Gonzalez De DiosTIME VISIT/
INSPECTION COMPLETED:
12:15 PM
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A case management inspection was conducted to the facility by Licensing Program (LPA) Leticia Rosales-Meza in response to an increase capacity application received by the Department on 03/18/24. 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 6:00 AM to 11:59 PM, Monday - Friday. The floor plan submitted by the licensee was reviewed and verified. The off-limits areas of the home are three bedrooms and three bathrooms, and were made inaccessible by door knob slip covers, and key locked doors. The home was observed to be clean and orderly, and was at a comfortable indoor temperature of 72 degrees Fahrenheit. Electrical outlets are covered and drapery cords are not accessible. The children's bathrooms were 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 will use the side yard as the outdoor play and is fully fence. There are no bodies of water on the property. Pediatric CPR and Pediatric First Aid cards expire 12/2024 for Licensee, and Licensee's qualified assistant. The Rohnert Park Rosa Fire Marshall inspected and granted the fire clearance on 3/29/24. 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, 04/29/24.
SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Leticia Rosales
LICENSING EVALUATOR SIGNATURE: DATE: 04/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/29/2024
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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