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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334843261
Report Date: 12/15/2022
Date Signed: 12/15/2022 02:32:32 PM


Document Has Been Signed on 12/15/2022 02:32 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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501



FACILITY NAME:AUTMAN FAMILY CHILD CAREFACILITY NUMBER:
334843261
ADMINISTRATOR:PEARLETTA AUTMANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 586-4675
CITY:DESERT HOT SPRINGSSTATE: CAZIP CODE:
92240
CAPACITY:14CENSUS: 0DATE:
12/15/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Pearletta Autman TIME COMPLETED:
02:35 PM
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LPAs Sharma and Mejorado attempted to conduct a visit for an overdue annual inspection. Licensee, Pearletta Autman granted access to the facility, but let LPA's know that she would need to leave by 2:35 to pick up children and take them to a game. LPA's said they would need to leave a report since they entered the home.

No children were present during the time of entrance.

Licensee was left with a Notice of Site (NOS), which needs to remain posted for 30 days. An exit interview was conducted and a copy of this report was provided to the licensee on this date.
SUPERVISOR'S NAME: Kimberly WilliamsTELEPHONE: (951) 805-5718
LICENSING EVALUATOR NAME: Aman SharmaTELEPHONE: (951) 970-7385
LICENSING EVALUATOR SIGNATURE:
DATE: 12/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/15/2022
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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