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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 485407956
Report Date: 03/23/2022
Date Signed: 03/24/2022 11:53:29 AM

Document Has Been Signed on 03/24/2022 11:53 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, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME:STANKEWITZ, ALICIA FAMILY CHILD CARE HOMEFACILITY NUMBER:
485407956
ADMINISTRATOR:STANKEWITZ, ALICIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(707) 635-3318
CITY:DIXONSTATE: CAZIP CODE:
95620
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 1DATE:
03/23/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Alicia StankewitzTIME COMPLETED:
03:10 PM
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On 3/23/2022 at 2:30 pm Licensing Program Analyst (LPA) Laura Chavez conducted an unannounced case management to the facility as a follow-up to the prelicensing inspection completed on 12/22/2021. At 2:40pm the home was toured inside and outside. LPA found the home to be in compliance. A gate at the bottom of the stairs prevents children from accessing the second floor of the home. LPA observed that the kiddie pool, ladder, and lawn mower have been removed from the backyard. Both entries leaving to the back of the shed have been made off-limits by means of a gate. A doorknob cover has been installed preventing children from entering the garage.

The report was reviewed with applicant Alicia Stankewitz.



Prior to granting a license the following is required:
1. Proof of completion of Preventative Health Practices training.
2. TB clearance for Bertha Rubio.

A 90-day provisional license may be granted once TB clearance for Bertha Rubio is received.
SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Laura Chavez
LICENSING EVALUATOR SIGNATURE: DATE: 03/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/23/2022
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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