<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 483008971
Report Date: 09/30/2022
Date Signed: 09/30/2022 11:13:17 AM


Document Has Been Signed on 09/30/2022 11:13 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405



FACILITY NAME:CURTIS, LATASHA FCCHFACILITY NUMBER:
483008971
ADMINISTRATOR:CURTIS, LATASHAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(707) 421-8106
CITY:SUISUN CITYSTATE: CAZIP CODE:
94585
CAPACITY:14CENSUS: 5DATE:
09/30/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:25 AM
MET WITH:Assistant Whitney RobertsTIME COMPLETED:
11:20 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program analyst (LPA) Elpidia Hernandez Torres arrived to the facility today to conduct a case management visit. LPA arrived to confirm Licensee's contact information and remind licensee of past due fees for both FCCH and Center. The regional office has received "return to sender" when items have been mailed out to center. When LPA calls contact number there is no return call or option to leave a voice message.

Licensee was not present in the home during todays visit. LPA spoke with Licensee's Assistant Whitney Roberts about the issues. Whitney was able to confirm Licensee's contact information and mailing address. Whitney stated the center was closed and closed permanently during the pandemic, but couldn't remember an exact date. LPA asked Whitney to have Licensee call LPA to confirm date of closure for the center, to have the center file closed Permanently. LPA left a copy of the fee invoice with the PIN should Licensee wish to pay online. Fees were due in March of 2022, there is now a Late fee added to the annual fee. A final notice was mailed out and fees are now do on 10/17/2022. If payment is not received license maybe forfeited.

There were no deficiencies observed during todays visit. Notice of site visit must be posted for 30 days.
SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Elpidia Hernandez TorresTELEPHONE: (707) 771-5568
LICENSING EVALUATOR SIGNATURE:
DATE: 09/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/30/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1