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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073408970
Report Date: 09/10/2020
Date Signed: 09/10/2020 05:52:54 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:LEE, JASMINEFACILITY NUMBER:
073408970
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 4DATE:
09/10/2020
TYPE OF VISIT:Case Management - OtherANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:JASMINE LEETIME COMPLETED:
01:00 PM
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1:OOPM: LPA ALEXANDER MET WITH LICENSEE JASMINE LEE FOR A VIRTUAL TA TELE-VISIT TO DISCUSS COVID-19 BEST SAFETY PRACTICES TO HELP THE FACILITY STAY HEALTHY DURING THE PANDEMIC. UPON THE BEGINNING OF THE VIRTUAL CALL, THIS LPA OBSERVES, 4 MINOR CHILDREN PRESENT ALONG WITH LICENSEE WHOM SHE IDENTIFIES AS 1 DAY CARE CHILD AND 3 OF HER OWN CHILDREN.

A CASE VIRTUAL MANAGEMENT TELE-VISIT IS ALSO BEING CONDUCTED TODAY TO OPEN UP THE PREVIOUS OFF LIMITS BONUS ROOM WHICH IS LOCATED ADJACENT TO THE DAY CARE ROOM THROUGH THE GLASS DOORS. TODAY A VIRTUAL WALK-THROUGH WAS CONDUCTED. THE ROOM IS FREE FROM ANY DEBRIS OR HAZARDS THAT MAY HARM CHILDREN IN CARE. THERE ARE NO CLOSETS OR BATHROOMS IN THE ROOM. THERE IS A DOOR THAT LEADS TO THE BACKYARD THAT NEEDS A CHILD LOCK TO PREVENT CHILDREN FROM EXITING, WHICH LICENSEE DOES HAVE AND WILL INSTALL. THIS ROOM WILL NOW BE USED AS AN EXTENSION OF PLAY FOR CHILDREN IN CARE AS OF TODAY.

THERE ARE NO DEFICIENCIES CITED TODAY. This report must be available for public review for 3 years. .
SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 873-6408
LICENSING EVALUATOR NAME: Tasha Hackett-AlexanderTELEPHONE: (510) 622-2618
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2020
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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