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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493009672
Report Date: 01/24/2020
Date Signed: 01/27/2020 08:42:40 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:BOCCALEONI, CINDY FCCHFACILITY NUMBER:
493009672
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 6DATE:
01/24/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:43 AM
MET WITH:Cindy BoccaleoniTIME COMPLETED:
01:13 PM
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
A case management visit was made to the facility by Licensing Program Analyst (LPA) Y. Yang at the request of the licensee to inspect and approve a newly assembled wooden play structure in the facility's front yard and to provide consultation regarding Title 22 regulations and Unusual Incident Report (UIR) reporting procedures.

LPA inspected the wooden play structure and observed that it is in good repair. The play structure is located in the facility's fully-fenced front play yard. The play structure includes a plastic slide and climbing wall that is approximately three feet off the ground. Due to insufficient cushioning material underneath the play structure, the play structure in not approved for child care use at this time. The licensee stated that she will submit pictures of the cushioning material once it has been added.

During today's case management visit, LPA observed six children being supervised by the licensee.There were no Title 22 deficiencies observed during today's inspection. Notice of Site Visit shall be posted for 30 days.
SUPERVISOR'S NAME: Alexis HollonTELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Yang YangTELEPHONE: 707-588-5026
LICENSING EVALUATOR SIGNATURE:

DATE: 01/24/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2020
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