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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 515408175
Report Date: 10/12/2023
Date Signed: 10/12/2023 11:11:30 AM

Document Has Been Signed on 10/12/2023 11:11 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, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME:GARCIA HERNANDEZ, SYNDYR FAMILY CHILD CARE HOMEFACILITY NUMBER:
515408175
ADMINISTRATOR:GARCIA HERNANDEZ, SYNDYRFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 923-3993
CITY:YUBA CITYSTATE: CAZIP CODE:
95991
CAPACITY: 14TOTAL ENROLLED CHILDREN: 10CENSUS: 6DATE:
10/12/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:40 AM
MET WITH:Syndyr Garcia Hernandez TIME COMPLETED:
11:15 AM
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On 10/12/2023 at 10:40am, a case management inspection was made to the facility by Licensing Program Analyst (LPA), Laura Chavez in response to the licensee's request to have her converted garage into a playroom added for children to use. A fire safety inspection approval for the conversion was received on 9/26/2023. LPA toured the playroom and added bathroom and found them to be in substantial compliance.

The converted garage into a play room is ready for children to use.

A notice of site visit was given and must remain posted for 30 days.

The report was reviewed with the licensee Syndyr Garcia Hernandez.
SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Laura Chavez
LICENSING EVALUATOR SIGNATURE: DATE: 10/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/12/2023
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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