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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343619798
Report Date: 05/22/2019
Date Signed: 05/22/2019 12:03:37 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:FARREN, MEGANFACILITY NUMBER:
343619798
ADMINISTRATOR:FARREN, MEGANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 215-8170
CITY:SACRAMENTOSTATE: CAZIP CODE:
95820
CAPACITY:14CENSUS: 12DATE:
05/22/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:10 AM
MET WITH:Megan FarrenTIME COMPLETED:
12:10 PM
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Licensing Program Analysts Tanya Washington and Marea Behvand met with Licensee, Megan Farren for a case management inspection regarding deficiencies cited during the annual inspection which was conducted on May 10th, 2019.

During today's inspection LPAs observed the facility to be within ratio and capacity. Licensee and her sister were providing care and supervision to 9 preschool age children and 3 infants.

LPAs are also clearing Type B citations for the following:

-Licensee has created files for the children who were missing a file and has updated files for the children who were missing certain documents.

- Licensee's assistants have enrolled for the required EMSA certified CPR and First Aid class on 05/25/2019.

- Licensee conducted a fire drill on 05/13/2019.

There is one pending Type B citation for required Measles and Pertussis vaccines for the staff which the Licensee has until 6/10/2019 to clear.

No deficiencies are cited during today's inspection.

Notice of site visit posted.
SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5744
LICENSING EVALUATOR NAME: Tanya WashingtonTELEPHONE: 916-879-1209
LICENSING EVALUATOR SIGNATURE:

DATE: 05/22/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2019
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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