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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191609404
Report Date: 12/14/2023
Date Signed: 12/14/2023 06:01:45 PM

Document Has Been Signed on 12/14/2023 06:01 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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:RUIZ-CHAVARIN FAMILY CHILD CAREFACILITY NUMBER:
191609404
ADMINISTRATOR:CONCEPCION RUIZ CH.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(424) 406-2106
CITY:CARSONSTATE: CAZIP CODE:
90746
CAPACITY: 12TOTAL ENROLLED CHILDREN: 12CENSUS: 4DATE:
12/14/2023
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME BEGAN:
04:50 PM
MET WITH:Licensee Concepcion Ruiz - ChavarinTIME COMPLETED:
06:15 PM
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Licensing Program Analyst (LPA) Alicia Mooberry and Licensing Program Manager (LPM) Valarie Cook made an unannounced case management visit for the purpose of serving the following documents:
  • Order To Individual of Immediate Exclusion from All Facilities: Jesus Sanchez.
  • Order To Licensee of Immediate Exclusion from Facility For Jesus Sanchez.


Present at the facility was Concepcion Ruiz - Chavarin. Jesus Sanchez was noted to be away at work during visit.

LPM Cook advised Licensee that Jesus Sanchez is excluded from Ruiz-Chavarin Family Child Care and any other facilities licensed by the Department of Social Services. Licensee and Jesus Sanchez have 15 days to submit an appeal. The address to appeal was provided.

LPM Cook advised Licensee of appeal process and reviewed inactive status. Licensee indicated she would temporarily change status of license to inactive starting 12/14/23 until 12/22/23.

Exit interview conducted with Licensee, copies of exclusion orders provided. A copy of this report will be emailed to Licensee.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE: DATE: 12/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/14/2023
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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