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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 485407767
Report Date: 03/05/2025
Date Signed: 03/05/2025 10:53:29 AM

Document Has Been Signed on 03/05/2025 10:53 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
SANTA ROSA CC RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:JONES, SKYLAR FAMILY CHILD CARE HOMEFACILITY NUMBER:
485407767
ADMINISTRATOR/
DIRECTOR:		JONES, SKYLARFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(707) 301-6793
CITY:VACAVILLESTATE: CAZIP CODE:
95687
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
03/05/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:35 AM
MET WITH:Not AvailableTIME VISIT/
INSPECTION COMPLETED:
10:55 AM
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Licensing Program Analyst (LPA), Cindy Castro made an unannounced Case Management inspection to the facility to verify operation at the facility, and to address the facility's forfeiture due to expired inactive status and non-payment of fees. Prior to today’s visit, numerous attempts were made to contact licensee on 09/13/24, 12/06/24, 12/30/24 and 01/31/25 regarding expired inactive status and past due fees.Licensee was notified of the closure/forfeiture through a letter sent on 03/03/25.

Upon arrival on 03/05/25, LPA observed a vehicle parked in driveway of facility. LPA rang doorbell twice and knocked on front door twice with no response. LPA called phone number on file and could hear the phone ringing inside the home, there was no response. LPA did not hear or observe any children in care. There was no evidence of operation and/or childcare being provided at the facility.

The approval for the closure/forfeiture of license has been met.

SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Cindy Castro
LICENSING EVALUATOR SIGNATURE: DATE: 03/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/05/2025
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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