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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343620505
Report Date: 08/05/2021
Date Signed: 08/05/2021 12:58:29 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:TOTS OF LOVEFACILITY NUMBER:
343620505
ADMINISTRATOR:VANESSA GRANTFACILITY TYPE:
850
ADDRESS:5619 MARCONI AVENUETELEPHONE:
(916) 689-8687
CITY:CARMICHAELSTATE: CAZIP CODE:
95608
CAPACITY:24CENSUS: 15DATE:
08/05/2021
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Sherrie MorrisTIME COMPLETED:
01:20 PM
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At 12:15 p.m. on Thursday, August 5th, 2021, Licensing Program Analyst (LPA) Karyn Guerra met with Director, Sherrie Morris, to conduct a POC inspection regarding a citation dated on 07/29/2021. At time of arrival, LPA observed a census of 15 children supervised by 4 staff. The facility was previously cited for criminal record clearance transfer. LPA received transfer forms LIC 9182 via email from Director on 7/30/2021. LPA requested required supporting documentation of criminal record statement and copy of government issued photo identification on 8/2/2021. LPA received requested supporting documents on 8/2/2021. LPA provided updated form LIC 508 criminal record statement and out of state disclosure to Director and staff during today's inspection. Criminal transfer citation has been corrected per POCs and has been cleared.
SUPERVISOR'S NAME: Seychelle De LucaTELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Karyn GuerraTELEPHONE: (916) 216-7790
LICENSING EVALUATOR SIGNATURE:

DATE: 08/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2021
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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