<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
283010007
Report Date:
04/11/2022
Date Signed:
04/11/2022 12:57:08 PM
Document Has Been Signed on
04/11/2022 12:57 PM
- It Cannot Be Edited
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY
FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office
,
1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA
,
CA
95405
FACILITY NAME:
MCGUIRE, KAILEY FCCH
FACILITY NUMBER:
283010007
ADMINISTRATOR:
MCGUIRE, KAILEY
FACILITY TYPE:
810
ADDRESS:
TELEPHONE:
(707) 260-5434
CITY:
NAPA
STATE:
CA
ZIP CODE:
94558
CAPACITY:
14
CENSUS:
2
DATE:
04/11/2022
TYPE OF VISIT:
Case Management - Other
UNANNOUNCED
TIME BEGAN:
12:40 PM
MET WITH:
Kailey McGuire
TIME COMPLETED:
01:10 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
LPA Kevin O'Connell made an unannounced inspection visit for the purpose of inspecting an additional room that was requested for child care use. An application and facility sketch were received on 3/10/22 to add the Living Room for child care use. The room was inspected and no hazards were observed. The fireplace is screened with glass and the electrical outlets were plugged.
The room is approved for use.
Notice of Site Visit is to be posted for 30 days from today.
SUPERVISOR'S NAME:
Leslie Lepori
TELEPHONE:
(707) 588-5060
LICENSING EVALUATOR NAME:
Kevin O'Connell
TELEPHONE:
(707) 588-5026
LICENSING EVALUATOR SIGNATURE:
DATE:
04/11/2022
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
04/11/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809
(FAS) - (06/04)
Page:
1
of
1