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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 394500128
Report Date: 06/12/2020
Date Signed: 06/12/2020 11:31:54 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:SAINEZ, CHARRONFACILITY NUMBER:
394500128
ADMINISTRATOR:SAINEZ, CHARRON ANNFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 784-6276
CITY:LATHROPSTATE: CAZIP CODE:
95330
CAPACITY:14CENSUS: 9DATE:
06/12/2020
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Charron SainezTIME COMPLETED:
11:30 AM
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Licensing Program Analyst (LPA) Alecia Sifuentes conducted a case management tele-inspection via Facetime with Licensee, Charron Sainez due to COVID-19 State of Emergency in lieu of an on-site visit. The purpose of the inspection is for approval of an above ground pool and spa located in the Licensee's backyard.

Licensee recently had an above ground pool and spa installed in the backyard of the home. Licensee has ensured pool fencing requirements are met. LPA reviewed the backyard and observed a metal/wooden fence has been installed completely surrounding the pool and spa. The fencing surrounding the body of water is over five feet high and completely surrounds the body of water. Licensee demonstrated the fence gate closure which is self closing/latching and swings away from the body of water.

Based on today's inspection, 6/12/2020, Licensee's pool fencing for an above ground pool meets title 22 regulation requirements. An exit interview was conducted and a notice of site visit will be emailed to Licensee to post in the facility.
SUPERVISOR'S NAME: Jeanne SmithTELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Alecia SifuentesTELEPHONE: (916) 917-9202
LICENSING EVALUATOR SIGNATURE:

DATE: 06/12/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/12/2020
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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