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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406214071
Report Date: 09/03/2020
Date Signed: 09/04/2020 11:32:29 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:LOUDAT FAMILY CHILD CAREFACILITY NUMBER:
406214071
ADMINISTRATOR:KIMBERLEY DIANNE LOUDATFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 423-5788
CITY:PASO ROBLESSTATE: CAZIP CODE:
93446
CAPACITY:14CENSUS: 10DATE:
09/03/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:58 PM
MET WITH:Kimberley LoudtTIME COMPLETED:
03:27 PM
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Licensing Program Analysts (LPA) Francisca Velazquez made an unannounced visit to conduct a Case Management inspection - Confirmation of Case Closure of Terry J. Lane. Due to COVID-19 precautionary measures and Public Health Ordinance of physical distancing, this was conducted via a tele-inspection using Zoom. LPA met with Licensee, Kimberley Loudat and explained the purpose of the inspection.

A virtual physical plant tour was conducted based on LPAs' direction. LPA and Licensee toured the indoor and outdoor of the facility.

LPA interview with the Licensee revealed that Terry J. Lane has not been working in the Family Child Care Home since March 13, 2020. LPA confirmed to Licensee that Terry J. Lane can not be working or present in the facility. Licensee understands and confirmed that Terry J. Lane has not been helping her in her facility.

Based on the evidence obtained during today’s visit, LPAs have verified Terry J. Lane is not present, nor currently employed in the facility. Licensee requested a copy of the letter from Department of Social Services.

No deficiencies were cited during this visit.

Notice of Site Visit was issued to be posted for the next 30 days.
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisca VelazquezTELEPHONE: (805) 883-8244
LICENSING EVALUATOR SIGNATURE:

DATE: 09/03/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2020
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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