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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 115407730
Report Date: 01/31/2022
Date Signed: 01/31/2022 11:20:50 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME:DRAKE, JESSICA FAMILY CHILD CARE HOMEFACILITY NUMBER:
115407730
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 1DATE:
01/31/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
11:05 AM
MET WITH:TIME COMPLETED:
11:30 AM
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Licensing Program Analyst, Grisak conducted a case management facility inspection on 1/31/22 at 11:05am. This inspection was in response to an application for increased capacity that was received by the Department on 12/15/21. The licensee has requested a capacity increase to 14 children.

The LPA toured the facilities indoor and outdoor areas. The off-limits areas of the home are the kitchen, dining room, laundry room and one bedroom, and were made inaccessible by baby gates and door knob covers. The children use the back yard as the outdoor play area and it is fully fenced. There were no pools or other bodies of water observed in the yard. The licensee was supervising 1 child at the time of the visit, and she was operating within the limitations of her current license ratio's. The LPA reviewed the ratio's for a large license and the licensee acknowledged she understood the ratio requirements. The LPA also reviewed the Safe Sleep and Lead Exposure Testing Flyer with the licensee.



Licensee's CPR/First Aid was completed and expires on 3/17/2022. Based on the space/accommodations available at this facility and the fire marshal granting their approval on 1/19/22 for the 14 children, the capacity increase request is granted. LPA will process this capacity increase and mail an updated license to reflect this capacity change to 14 children. An exit interview was conducted with licensee.

Notice of Site Visit was given to licensee to post for 30 days.
SUPERVISOR'S NAME: Erin VirruetaTELEPHONE: (530) 895-4325
LICENSING EVALUATOR NAME: Emilia GrisakTELEPHONE: (530) 895-5821
LICENSING EVALUATOR SIGNATURE:

DATE: 01/31/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2022
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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