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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493010560
Report Date: 05/01/2024
Date Signed: 05/01/2024 01:38:52 PM

Document Has Been Signed on 05/01/2024 01:38 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:OLIVEIRA, FLAVIA & DAVID FCCHFACILITY NUMBER:
493010560
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 1CENSUS: 0DATE:
05/01/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:51 AM
MET WITH:Flavia and David OliveiraTIME VISIT/
INSPECTION COMPLETED:
01:07 PM
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A post licensing visit was made to the facility by Licensing Program Analyst (LPA) Y. Yang at the request of the licensee to provide technical assistance. The licensee is updating the age range of children to be cared for from birth to five years of age.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensees, Flavia and David Oliveira. There were no Title 22 deficiencies cited during today's inspection.
SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Yang Yang
LICENSING EVALUATOR SIGNATURE: DATE: 05/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/01/2024
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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