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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073408994
Report Date: 01/16/2020
Date Signed: 01/16/2020 03:28:53 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:FORD, TAMIKAFACILITY NUMBER:
073408994
ADMINISTRATOR:FORD, TAMIKAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 776-3410
CITY:RICHMONDSTATE: CAZIP CODE:
94801
CAPACITY:14CENSUS: 0DATE:
01/16/2020
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Tamika FordTIME COMPLETED:
04:00 PM
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An announced prelicensing follow-up site inspection visit was conducted by LPA Susan Neeson. Met with Tamika Ford, Applicant. The visit began at 2:30 PM. There are no children present.

The purpose of the visit is to determine if items not completed during last visit are currently in place. Control of property was reviewed. The heater has a secure barricade. The fire clearance was dated 12/31/19. The home was inspected for health and safety. The yard was inspected. The well was covered with wood on all sides and top. The cover supports the weight of an adult. There is also a shed in the yard in which there are tools and other stored items. It is securely locked. Yard can be used for day care children. Additional furniture has been added to the home. The bulletin board has been set up. Day care will be done in the living/dining area, sun room and kitchen. The bathroom will be used for children. Handrail has been added to the steps from the living/dining area to sun room.

As of today the facility is ready to be licensed as a large Family Child Care.

The license will be processed as soon as is administratively possible.

An exit interview was given.
SUPERVISOR'S NAME: Antranette RobinsonTELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Susan NeesonTELEPHONE: (510)622-2630
LICENSING EVALUATOR SIGNATURE:

DATE: 01/16/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2020
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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