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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 293623969
Report Date: 07/12/2024
Date Signed: 07/12/2024 02:20:55 PM

Document Has Been Signed on 07/12/2024 02:20 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:BECERRA, LAURAFACILITY NUMBER:
293623969
ADMINISTRATOR/
DIRECTOR:		LAURA BECERRAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 798-3002
CITY:GRASS VALLEYSTATE: CAZIP CODE:
95945
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 7DATE:
07/12/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:55 PM
MET WITH:Laura BecerraTIME VISIT/
INSPECTION COMPLETED:
02:30 PM
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At 1:55pm on 7/12/2024, Licensing Program Analyst (LPA) Matthew Gallo met with licensee Laura Becerra for the purpose of an unannounced plan of correction visit. Upon arrival, LPA observed a total census of 7 children, consisting of 2 school aged children, 3 preschool children, and 2 infants.

Licensee was previously cited a Type A deficiency on 6/28/2024 for the presence of a sleeping infant in an off-limit area of the home. The plan of correction dictated that the licensee would move the crib of the infant to the on-limits living room and that LPA would conduct a return visit to ensure compliance. Upon arrival, LPA observed that the crib with the sleeping infant was in the on-limits living room, and that no children were in off-limit areas of the home. The plan of correction has been fulfilled, and the citation of 6/28/2024 has been cleared. In the future, licensee understands that they must notify licensing prior to changing any area of the home previously identified off-limits to an area where care and supervision of children can be provided.

No further deficiencies were cited during the visit.

Exit interview conducted and report was reviewed with the licensee, Laura Becerra. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Matthew Gallo
LICENSING EVALUATOR SIGNATURE: DATE: 07/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/12/2024
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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