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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393612010
Report Date: 12/08/2021
Date Signed: 12/08/2021 09:05:00 AM

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:PALMA, ESMERALDAFACILITY NUMBER:
393612010
ADMINISTRATOR:PALMA, ESMERALDAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 462-8891
CITY:STOCKTONSTATE: CAZIP CODE:
95206
CAPACITY:14CENSUS: 6DATE:
12/08/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Esmeralda PalmaTIME COMPLETED:
09:10 AM
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On 12/08/2021 at 8:30 AM Licensing Program Analyst (LPA) Jeevun Birk-Miller conducted a case management inspection and met with Licensee, Esmeralda Palma. There were six children in care during the inspection. The Licensee's assistant was also present. The purpose of the inspection was to inspect the newly installed pool fencing and in ground pool located in the backyard. Licensee has ensured pool fencing requirements are met. LPA toured the backyard and observed a rod iron fence installed that encloses the pool area. The rod iron fencing is attached to the backyard's existing wood fencing and cinder block wall. LPA did measurements around the fencing. The base of fence to the top of the fence measured at six feet. There is a retaining wall, but the rod iron fence was extended to six feet above and the paneling to the left measures close to eight feet. The fencing does not obstruct the view of the pool. The gate swings away from the pool and is self-latching and closing.

Based on today's inspection, the Licensee's pool fencing for the in ground pool meets Title 22 regulation requirements. An exit interview was conducted and no deficiencies were cited at this time. A notice of site visit was given.
SUPERVISOR'S NAME: Jeanne SmithTELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Jeevun BirkTELEPHONE: (916) 917-6078
LICENSING EVALUATOR SIGNATURE:

DATE: 12/08/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/08/2021
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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