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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 483009843
Report Date: 05/15/2020
Date Signed: 05/15/2020 11:06:32 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928
FACILITY NAME:SCRIBNER, CLAIRE FCCHFACILITY NUMBER:
483009843
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 0DATE:
05/15/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Claire ScribnerTIME COMPLETED:
10:30 AM
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Licensing Program Analyst (LPA) Glenn Ouye conducted a video tele-visit case management visit due to the Covid-19 pandemic. The tele-visit was made in place of an in-person, site visit.

The case manage visit was conducted due to the licensee's request for a capacity increase. The licensee met with the Benicia Fire Inspector on May 14, 2020. The fire inspector approved the capacity change from a small family child care home to a large family child care home on the date of the meeting. LPA Ouye received a copy of the approved fire inspection on May 14, 2020.

The licensee toured LPA Ouye through the facility via a zoom video meeting. The licensee showed LPA the newly installed pull station which is located near the front door. The smoke detectors are now interconnected. The fire extinguisher has been mounted on the wall hear the front door.

Effective May 15, 2020 this family child care home is approved to operate as a large family child care home.
SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Glenn OuyeTELEPHONE: (707) 588-5042
LICENSING EVALUATOR SIGNATURE:

DATE: 05/15/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2020
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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