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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343619138
Report Date: 03/13/2020
Date Signed: 04/01/2020 02:46:39 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:BARRETT, CHAROLFACILITY NUMBER:
343619138
ADMINISTRATOR:BARRETT, CHAROLFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 758-7160
CITY:SACRAMENTOSTATE: CAZIP CODE:
95823
CAPACITY:14CENSUS: 2DATE:
03/13/2020
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Charol BarrettTIME COMPLETED:
12:00 PM
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This is an amended report.
On Friday, March 13,2020 at 11:03 AM Licensing Program Analyst (LPA), Elvira Sierra, met today with Licensee, Charol Barrett for a Plan Of Correction (POC) inspection. Present in the facility was Licensee caring for 2 preschool children.

LPA observed carbon monoxide detector in the home and Licensee has renew her CPR and expires on 03/07/22. Children files were reviewed and are complete. The facility is in compliance today.


Deficiencies issued on 02/11/20 are cleared as a today.


*No deficiencies cited today under Title 22 Division 12 of the Ca. Code of Regulations*.

>This report was reviewed and discussed with Licensee. This report must be available in the facility for public review. Notice of site visit was observed being posted.
SUPERVISOR'S NAME: Bettina EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Elvira SierraTELEPHONE: (916) 216-8826
LICENSING EVALUATOR SIGNATURE:

DATE: 03/13/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2020
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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