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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 093622591
Report Date: 11/16/2020
Date Signed: 11/17/2020 10:54:50 AM

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:REED, ELIZAFACILITY NUMBER:
093622591
ADMINISTRATOR:REED, ELIZAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 676-7222
CITY:SHINGLE SPRINGSSTATE: CAZIP CODE:
95682
CAPACITY:14CENSUS: 0DATE:
11/16/2020
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Eliza ReedTIME COMPLETED:
03:45 PM
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On 11/16/20 at 3:00pm, due to COVID-19 pandemic, Licensing Program Analyst (LPA), Jan Hoshida, met with Licensee, Eliza Reed, via Zoom for the purpose of a case management tele-inspection. All individuals subject to criminal background review have obtained a criminal record clearance.

Licensee renovated the garage to become a classroom space. On 11/3/2020, Licensee contacted LPA to request to make the garage on-limits. On 11/12/20, LPA received an updated fire clearance from El Dorado County Fire Department for the use of the renovated garage for day care.

During today's tele-inspection, LPA inspected the garage and observed that it is free from hazards and in compliance with Title 22 regulations and the Health and Safety code. Effective today, the gargage is on-limits. Licensee understands she must contact LPA to make any off-limit areas on-limits, and vice versa. Licensee acknowledges that off-limit areas will remain inaccessible by closed doors and/or supervision.

A Notice of Site Visit was provided and should remain posted for 30 days.

Facility evaluation report was emailed to Licensee and an email verification of receipt of report will be used in lieu of a signature on this report.

SUPERVISOR'S NAME: Bettina EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Jan HoshidaTELEPHONE: (916) 917-6572
LICENSING EVALUATOR SIGNATURE:

DATE: 11/16/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/16/2020
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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