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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393623022
Report Date: 05/24/2019
Date Signed: 05/24/2019 09:40:03 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:PADILLA, GIULIANAFACILITY NUMBER:
393623022
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 2DATE:
05/24/2019
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Giuliana PadillaTIME COMPLETED:
10:00 AM
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Licensing Program Analyst (LPA) Christopher Jackson met with applicant Giuliana Padilla for a return follow up pre-licensing inspection. During the previous pre-licensing inspection, LPA observed the fence line to the left side of the backyard to have gaps between the boards and provide a potential access into a neighbors backyard that has an in ground pool. LPA also observed nails and screws to be sticking out of the fence line.

During today's follow up inspection LPA observed plywood mounted to the fence to prevent any direct access points into the adjacent backyard. LPA observed nails and screws sticking out of fence to be either removed or secured.

Effective today 05/24/19 LPA is granting a small family child care home license to serve a capacity of 6 children with no more than 3 infants or 4 infants only. Or with a capacity of 8 children: no more than 2 infants, 1 child in kindergarten or elementary school and 1 child at least age 6.
SUPERVISOR'S NAME: Sharon OgbodoTELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Christopher JacksonTELEPHONE: (916) 216-8837
LICENSING EVALUATOR SIGNATURE:

DATE: 05/24/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2019
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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