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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 293623581
Report Date: 04/09/2021
Date Signed: 04/09/2021 09:41:42 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:LITTLE GEMSFACILITY NUMBER:
293623581
ADMINISTRATOR:FIERRO, ANDORRAFACILITY TYPE:
850
ADDRESS:908 NORTHSTAR DRIVETELEPHONE:
(530) 448-4522
CITY:TRUCKEESTATE: CAZIP CODE:
96161
CAPACITY:30CENSUS: 18DATE:
04/09/2021
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Andorra Fierro - DirectorTIME COMPLETED:
09:45 AM
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NOTE: Due to Covid-19 and DPH guidelines on physical distancing, a Tele-visit via FaceTime was conducted.
On Friday, April 9th, 2021, at 8:30am, Licensing Program Analyst (LPA) Blake Morillas conducted a Case Management visit for the purpose of increasing the capacity by 10 children, which would increase total capacity from 30 to 40 children. Current indoor measurements along with current bathrooms for children, as noted in the Prelicensing report dated 5-28-2020, do allow for the increase of 10 children by itself. A Fire Clearance has been received and the facility has been approved by the fire department for a total capacity of 40 children. Nevertheless, the facility is requesting the use of an additional classroom located on the bottom floor to the left (at this time there is no assigned room number). At 8:34am, with the help of the Director, a virtual inspection of the requested space was conducted. The added space consists of a classroom with attached office space for the staff as well as a bathroom that at this time will be used for staff only. The Director noted that this may change in the future. The Director was informed that if the use does change, another visit will be needed before being approve for children use. The classroom was observed to be equipped with child size furnishings. There is ample shelving and cabinet space to store individual children's personal belongings. Based on the measurements provided by the Director, the total usable square footage of the classroom equals 504 square feet, which in addition to the pre-approved interior space of 1,715.695 square feet, is sufficient to meet the request of 10 additional children. With the addition of the room and bathrooms, the facility will now consist of 4 classrooms, 3 toilets and 3 sinks for usage by the children.
Please note: When a physical inspections takes place, requests for alterations may be made.
The outdoor space remains unchanged and the existing playground waiver remains in effect.
Pending final approval, the Facility's new total capacity will be 40 children.
This report (LIC 809), Appeal Rights (LIC 9058) and a Notice of Site Visit (LIC 9213) will be delivered to the Director electronically via email.
Acknowledgement of delivery will constitute acknowledgement of the report in lieu of a signature
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Blake MorillasTELEPHONE: (916) 208-3734
LICENSING EVALUATOR SIGNATURE:

DATE: 04/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2021
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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