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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 053615832
Report Date: 11/09/2020
Date Signed: 11/09/2020 03:31:40 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME:ROWITZ, HARMONYFACILITY NUMBER:
053615832
ADMINISTRATOR:ROWITZ, HARMONYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 736-4383
CITY:ANGELS CAMPSTATE: CAZIP CODE:
95222
CAPACITY:14CENSUS: 7DATE:
11/09/2020
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Harmony RowitzTIME COMPLETED:
02:15 PM
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Licensing Program Analyst (LPA) Justin Denton met with Licensee Harmony Rowitz for a case management inspection. This meeting was conducted over video-chat using Google Duo due to the ongoing COVID-19 pandemic. Off limits areas currently include: master bedroom/bathroom, daughter's bedroom, guest bedroom, and side-yards.

Licensee is expanding facility to include the guest bedroom, which will be used as an infant nap room. As of today, 11/9/2020, the guest bedroom will be an on-limits area accessible to children in care.

LPA virtually toured guest room and observed it to be free of hazards. LPA advised licensee to update her Lic 999A Facility Sketch.

Exit interview conducted and a copy of this report was emailed to the licensee. Licensee agreed to sign and return this report.
SUPERVISOR'S NAME: Jeanne SmithTELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Justin L DentonTELEPHONE: (916) 926-9269
LICENSING EVALUATOR SIGNATURE:

DATE: 11/09/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2020
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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