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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313607118
Report Date: 04/12/2022
Date Signed: 04/12/2022 12:30:01 PM


Document Has Been Signed on 04/12/2022 12:30 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, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833



FACILITY NAME:LIEBE, LOREEFACILITY NUMBER:
313607118
ADMINISTRATOR:LIEBE, LOREEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 847-0038
CITY:LOOMISSTATE: CAZIP CODE:
95650
CAPACITY:14CENSUS: 10DATE:
04/12/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Loree LiebeTIME COMPLETED:
12:45 PM
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Licensing Program Analyst, Amanda Blesi arrived to the facility to conduct a case management inspection. LPA met with licensee Loree LIebe. There were 10 children in care, all of whom are over age two. Also present was licensee's assistant, Susan Smith. The purpose of today's inspection is to conduct a health and safety evaluation of a new fenced play area that licensee has added to the property. There is a pool located at the house next door (on the same property) which is owned by licensee's mother. The fenced play area is made of wrought iron fencing that is at least 5 feet high. LPA observed the two gates self close and self latch. The play area is approved for use effective today.
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Amanda BlesiTELEPHONE: (916) 208-3427
LICENSING EVALUATOR SIGNATURE:
DATE: 04/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/12/2022
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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