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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 394500181
Report Date: 02/19/2020
Date Signed: 02/19/2020 10:07:57 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:RICH, ALICIAFACILITY NUMBER:
394500181
ADMINISTRATOR:RICH, ALICIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 858-8642
CITY:MANTECASTATE: CAZIP CODE:
95336
CAPACITY:14CENSUS: 0DATE:
02/19/2020
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Alicia RichTIME COMPLETED:
10:15 AM
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On 02/19/20202, Licensing Program Analyst (LPA) Christopher Jackson met with applicant Alicia Rich for a Change of Location inspection. LPA observed zero children in care during the inspection. The applicant moved into a single story home, that consists of an attached garage, kitchen, living room, formal dining area, three bedrooms located down the left hall, and two bathrooms. The front yard is unfenced. LPA discussed 100% supervision if children are in the front yard. There is a fully fenced in backyard with a wooden play structure. The Off limit areas include garage, master bedroom, and left side yard upon entry into the home.

LPA observed all areas of the home during today's inspection. LPA observed no bodies of water on the property. Toxins and dangerous items were found inaccessible. LPA observed a wood burning stove in the home. Applicant stated the fireplace will not used be in the home. LPA discussed the fireplace must be barricaded for children if the fireplace were to be used. Applicant provided a copy of the mortgage statement during today's inspection.

Applicant stated there are no weapons in the home. Applicant’s CPR/First Aid certification expires 02/23/21. All adults in the home have criminal record clearances. In addition, LPA tested the smoke alarm, carbon monoxide detectors and fire extinguisher meet Title 22 regulations. A copy of the Fire Clearance was received on 02/18/2020 from the Manteca Fire Department . A copy of has been placed in the applicants file.

LPA reviewed licensing forms and provided the licensing website, www.ccld.ca.gov, so applicant may download forms, or review regulations.

Effective today, 02/19/2020, LPA is granting a large family child care license to serve 12 children (when there is an assistant present) with no more than 4 infants or capacity of 14 children with 1 child in transitional kindergarten or elementary school and 1 child at least age 6 and a maximum of 3 infants. Infants are children under the age of 2 years old.
SUPERVISOR'S NAME: Sharon OgbodoTELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Christopher JacksonTELEPHONE: (916) 216-8837
LICENSING EVALUATOR SIGNATURE:

DATE: 02/19/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/19/2020
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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