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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444414540
Report Date: 11/03/2021
Date Signed: 11/03/2021 03:07:06 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:LOBELL, LORI BETHFACILITY NUMBER:
444414540
ADMINISTRATOR:LOBELL, LORI BETHFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 239-0117
CITY:SANTA CRUZSTATE: CAZIP CODE:
95060
CAPACITY:14CENSUS: 11DATE:
11/03/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Lori Beth LobellTIME COMPLETED:
03:15 PM
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Licensing Program Analyst (LPA) Goodell met with licensee Lori Beth Lobell for a case management inspection to follow up on licensee's converted garage used for child care activities. During inspection LPA observed seven children in indoor napping area and four children in the outdoor area located in yard. Licensee, licensee's husband and assistant were present. All individuals subject to criminal background review have obtained a criminal record clearance.

During inspection LPA toured all areas accessible to children which include converted garage used for playroom and naptime, restroom (located in the home next to laundry room) outdoor play house, two bedrooms. Licensee informed LPA that since COVID two bedrooms are no longer used for childcare and requested to have the rooms off-limits. LPA discussed alterations to existing buildings or grounds per Title 22, 102416.3. LPA observed a fire extinguisher 3A40BC, smoke detector and carbon monoxide detector in the day care room.

No deficiencies cited. This facility evaluation report was reviewed and discussed with the licensee. A notice of site visit issued and remain posted for 30 days. Licensee acknowledged that a copy of this report will remain on file for a period of three years for public review upon request.
SUPERVISOR'S NAME: Diana StephensonTELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Kristal GoodellTELEPHONE: (408) 489-9484
LICENSING EVALUATOR SIGNATURE:

DATE: 11/03/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2021
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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