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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 483007389
Report Date: 07/27/2022
Date Signed: 07/27/2022 01:58:05 PM

Document Has Been Signed on 07/27/2022 01:58 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, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:MCCALL-BRAGA, VICKKI FAMILY CHILD CARE HOMEFACILITY NUMBER:
483007389
ADMINISTRATOR:MCCALL- BRAGA, VICKKIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(707) 642-2521
CITY:VALLEJOSTATE: CAZIP CODE:
94589
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
07/27/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:20 PM
MET WITH:Licensee unavailableTIME COMPLETED:
02:00 PM
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Licensing Program Analyst (LPA), Melchisedeck Augustin made an announced Case Management visit to verify operation status of the facility. On 07/22/22, the Department received information indicating the facility was no longer operating. During today's visit, the Licensee, Vickki McCall-Braga (LS) was not present and the current resident (A1) of the home provided a written statement, confirming the Licensee did not reside in the home and the home was not operating a childcare facility. There was no indication that a childcare facility was being operated in the home and LPA did not see any daycare children in the home. The facility license is forfeited in accordance with California Code of Regulations (CCR) 102383(a)(1), and the license will be closed effective, 07/27/2022. The Licensee was unavailable to review or sign the report.
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Melchisedeck Augustin
LICENSING EVALUATOR SIGNATURE: DATE: 07/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/27/2022
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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