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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 093612147
Report Date: 09/28/2022
Date Signed: 09/28/2022 12:15:30 PM

Document Has Been Signed on 09/28/2022 12:15 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, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:MARVOS, CATHYFACILITY NUMBER:
093612147
ADMINISTRATOR:MARVOS, CATHYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 409-9297
CITY:CAMINOSTATE: CAZIP CODE:
95709
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 3DATE:
09/28/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Anarose FerroTIME COMPLETED:
12:30 PM
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On Wednesday, September 28th, 2022 at 12:00 PM, Licensing Program Analyst (LPA) Arianna Manabat met with Facility Representative Anarose Ferro for the purpose of an unannounced plan of correction inspection. There were three children present at the facility. All individuals subject to criminal background review have obtained a criminal record clearance.

During today's visit, LPA observed that the facility is operating within ratio requirements and has not exceeded the limitations listed on the license. As of 09/28/2022, LPA Manabat has cleared the type A deficiency cited previously cited on 09/20/2022 as there are only three children present with the Licensee's assistant.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Facility Representative.

SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Arianna Manabat
LICENSING EVALUATOR SIGNATURE: DATE: 09/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/28/2022
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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