343623696-9-29-2021-03-CC-KFEA-C7BU9X-20210929152351

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343623696
Report Date: 09/29/2021
Date Signed: 09/29/2021 03:23:54 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:	STEVENSON, MONICA & ORLANDO		FACILITY NUMBER:	343623696
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 5	DATE:	09/29/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	03:00 PM
MET WITH:	Orlando Stevenson		TIME COMPLETED:	03:45 PM

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Licensing Program Analyst (LPA) Kelly Ferrara met with Licensee Orlando Stevenson to conduct a Change of Capacity inspection. The Licensee is requesting an increase from eight to 14 children. Today's census was five children in care with the Licensee.

Off-limit areas include: All three bedrooms, master bathroom, and garage. Licensee acknowledged that children may never enter these off-limit areas. LPA observed a fire extinguisher and functioning smoke alarm and carbon monoxide detector. LPA observed the required Licensing postings on the wall and a current CPR/1st aid certification, which expires August 2022. LPA observed that hazardous items and chemicals were stored inaccessible to children in care. LPA did not observe any bodies of water on the premises and Licensee stated there were no firearms. LPA observed the home was clean, safe, sanitary, and in good repair with appropriate toys for the children. In the areas that were evaluated during today's inspection, the facility is in compliance.

A Fire Safety Inspection Clearance has been received from Sacramento County and the home has been cleared for up to 14 children.

Applicant is now approved to operate as a Large Family Child Care Home as of today, September 29th, 2021. Facility is now licensed to serve a maximum capacity (when there is an assistant present) of 12 children with no more than four infants OR a capacity of 14 children no more than three Infants; one child must be in Transitional Kindergarten/Elementary School and one child must be at least six years old. If there is not an assistant present, the facility must revert to a Small Family Child Care Home license.

LPA reviewed the report with the Licensee and a copy was provided. Notice of Site was posted and must remain for 30 days.

SUPERVISOR'S NAME: Maria Mayorga	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Kelly Ferrara	TELEPHONE: (916) 425-5932
LICENSING EVALUATOR SIGNATURE:	DATE: 09/29/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2021

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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