<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343621637
Report Date: 01/12/2021
Date Signed: 01/12/2021 01:24:23 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:PIERCE, TIFFANYFACILITY NUMBER:
343621637
ADMINISTRATOR:PIERCE, TIFFANYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 743-0397
CITY:SACRAMENTOSTATE: CAZIP CODE:
95833
CAPACITY:14CENSUS: 7DATE:
01/12/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Tiffany PierceTIME COMPLETED:
01:24 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Due to the COVID-19 pandemic, Licensing Program Analyst (LPA) Joleen Kenney is conducting the meeting via FaceTime with the Licensee.

On 1/12/2020 at 1:00 p.m., LPA Kenney conducted a case management inspection and spoke with the Licensee, Tiffany Pierce. There were seven children in care today. The purpose of today's inspection was to view the sun room addition that the Licensee had built on to the back of her home. The Licensee has requested to make the sun room as an on-limit area and accessible for children to play.

LPA Kenney toured the home via FaceTime with the Licensee and viewed the new sun room and there were no hazards observed to be accessible to children in care. The Licensee provided photos of the sun room, a copy of the building permit, and an updated facility sketch that includes the sun room addition for the licensing file.

As of today, the sun room addition may be used by day-care children.

In lieu of Licensee's signature, LPA Kenney is e-mailing the report with a read receipt request.
SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Joleen KenneyTELEPHONE: (916) 799-9668
LICENSING EVALUATOR SIGNATURE:

DATE: 01/12/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 1