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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343620842
Report Date: 01/14/2020
Date Signed: 01/14/2020 03:13:11 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:ITURRIZAGA, CLAUDIAFACILITY NUMBER:
343620842
ADMINISTRATOR:ITURRIZAGA, CLAUDIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 519-3034
CITY:SACRAMENTOSTATE: CAZIP CODE:
95821
CAPACITY:14CENSUS: 6DATE:
01/14/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Claudia IturrizagaTIME COMPLETED:
04:15 PM
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LPA Kelly met with licensee and her assistant to discuss the events happening at the home. Licensee spoke with LPA on the phone on 1/13/20, she explained the kitchen in the home is been renovated starting on 1/13/20. LPA toured the home and observed 6 day care children present. Children will not use the kitchen and dining areas until the renovation is finished in about a week. Children will use the living room and the day care room/nap room, licensee has food and water provisions for the children.
SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5744
LICENSING EVALUATOR NAME: Socorro KellyTELEPHONE: (916)216-7792
LICENSING EVALUATOR SIGNATURE:

DATE: 01/14/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2020
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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