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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313615176
Report Date: 02/16/2021
Date Signed: 02/16/2021 05:36:32 PM

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:CUNNINGHAM, ROBINFACILITY NUMBER:
313615176
ADMINISTRATOR:CUNNINGHAM, ROBINFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 906-2890
CITY:AUBURNSTATE: CAZIP CODE:
95603
CAPACITY:14CENSUS: 5DATE:
02/16/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:42 PM
MET WITH:Robin CunninghamTIME COMPLETED:
04:15 PM
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Licensing Program Analyst (LPA) Mai Lor and Regional Manager (RM) Jennifer Brekke conducted an unannounced case management inspection and met with licensee Robin Cunningham on 2/16/21 for the purpose of serving a Temporary Suspension Order (TSO). During this inspection, RM Brekke explained to licensee Robin Cunningham the purpose of the visit and explained the contents of the TSO documents.

The following documents are included in the TSO packet: Order for Temporary Suspension of License Prior to Hearing, Statement to Respondent, Government Code sections, Instructions For Licensee about the Summary of Charges, Accusation (License Revocation), Request for Discovery and Notice of Defense (2 copies).

Robin Cunningham was made aware that the facility may not operate after close of business on February 16, 2021.

Notice Closed for Business LIC9031 was placed on the front door.

SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Mai LorTELEPHONE: (916) 491-0182
LICENSING EVALUATOR SIGNATURE:

DATE: 02/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/16/2021
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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