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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 480110249
Report Date: 08/07/2023
Date Signed: 08/07/2023 11:05:29 AM

Document Has Been Signed on 08/07/2023 11:05 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, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:BANZET, PHUOC FAMILY CHILD CARE HOMEFACILITY NUMBER:
480110249
ADMINISTRATOR:BANZET, PHUOCFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(707) 449-0714
CITY:VACAVILLESTATE: CAZIP CODE:
95687
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
08/07/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:40 AM
MET WITH:Licensee unavailableTIME COMPLETED:
11:15 AM
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Licensing Program Analyst (LPA), Melchisedeck Augustin made an attempted unannounced Case Management visit to verify the facility’s operational status. On 08/02/23, the Licensee, Phuoc Banzet (LS) forfeited the original license with a written statement reflecting that she was no longer interested in operating a childcare facility.

During today’s attempted visit, LPA observed several vehicles parked in the facility driveway, but it appeared that LS was not home because there was no answer at the front door. Furthermore, LPA made an attempted telephone call to LS, but the voicemail did not provide the option to leave a voice message. Although, LS was unavailable to provide LPA with a tour of the home, LPA did not see any indication or evidence of a childcare facility being operated out of the home. LPA did not see or hear children, and the facility license is forfeited in accordance with CCR 102383(a)(1), and the license will be closed effective, 08/042023.


This report as well as, license exemptions of California Code of Regulations (CCR) 102358 Which indicates a family day care home may provide care for the children of only one family in addition to the operator's own children, will be mailed to LS. Licensee was unavailable for signature.
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Melchisedeck Augustin
LICENSING EVALUATOR SIGNATURE: DATE: 08/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/07/2023
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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