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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313621737
Report Date: 09/09/2020
Date Signed: 09/09/2020 08:06:13 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:WILKINS, VICTORIAFACILITY NUMBER:
313621737
ADMINISTRATOR:WILKINS, VICTORIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 770-0241
CITY:ROSEVILLESTATE: CAZIP CODE:
95747
CAPACITY:14CENSUS: 11DATE:
09/09/2020
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
07:30 AM
MET WITH:Victoria Wilkins - LIcenseeTIME COMPLETED:
08:00 AM
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An announced case management virtual video tour inspection was conducted today by LPA Owens, due to COVID-19. LPA met with licensee, Victoria Wilkins via Face-time.

The purpose of the case management virtual video tour was to observe a spa located in the backyard. LPA observed the covered spa that has latched straps; in good working condition, and a bar going across the top of the spa. The spa stool is out of the reach of children. Licensee understands she will provide adequate supervision when children are in the backyard and the spa will not be used during day care hours.

No deficiencies were observed at time of inspection.
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Katrina OwensTELEPHONE: 916-263-6280
LICENSING EVALUATOR SIGNATURE:

DATE: 09/09/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2020
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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