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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313620786
Report Date: 07/15/2022
Date Signed: 07/18/2022 03:36:20 PM


Document Has Been Signed on 07/18/2022 03:36 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:ARANT, AMYFACILITY NUMBER:
313620786
ADMINISTRATOR:ARANT, AMYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 368-0500
CITY:APPLEGATESTATE: CAZIP CODE:
95703
CAPACITY:14CENSUS: 8DATE:
07/15/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:15 PM
MET WITH:Amy ArantTIME COMPLETED:
04:15 PM
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On July 18, 2022 around 3:15 pm Licensing Program Analyst (LPA) Lea Habtom met with licensee Amy Arant for the purpose of an unannounced case management visit to amend the findings of the complaint delivered on June 29, 2022. The census during today's visit is 5 preschool children and 3 school age children being supervised by licensee and her assistant. Licensee's two son's were present in the home.

There were no Title 22 deficiencies cited during today's inspection. Notice of site visit provided. Exit interview conducted.
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Lea HabtomTELEPHONE: (916) 208-2538
LICENSING EVALUATOR SIGNATURE:
DATE: 07/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/18/2022
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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