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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 214005500
Report Date: 07/28/2021
Date Signed: 07/28/2021 12:43:47 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:TAVARES, ELISABETH BP & TAVARES.ISADORAFACILITY NUMBER:
214005500
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 5DATE:
07/28/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:11 AM
MET WITH:Licensees, Isadora & ElisabethTIME COMPLETED:
01:00 PM
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Licensing Program Analyst (LPA) Kassandra Medrano conducted a case management inspection today in response to an application submitted by Elisabeth & Isadora Tavares for an Increase to a large family home child care license. LPA also conducted an annual required inspection of the home today and that inspection is documented on a separate LIC 809 dated today's date 7/28/21, and marked as an annual required inspection. There were no deficiencies cited under that inspection report. LPA Medrano toured the home with Licensees. Licensee rents the home. LPA Medrano reviewed the requirements for a large family child care license, including capacity and ratio, and assistant/helper requirements. LPA Medrano also reviewed the updated Title 22 Regulation changes regarding napping/sleeping infants, and provided Ella with a copy of the updated Regulation Section.
Fire clearance has been received from Corte Madera Fire as of 7/26/2021.

Report is being emailed today to licensee.

Facility has been approved for Large family child care as of today, 7/28/2021
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Kassandra MedranoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 07/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2021
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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