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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423838
Report Date: 11/02/2022
Date Signed: 11/02/2022 01:12:40 PM

Document Has Been Signed on 11/02/2022 01:12 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
BAY AREA-CC OAKLAND, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:LAFITTE, ILEITAFACILITY NUMBER:
013423838
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 5DATE:
11/02/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Ileita LafitteTIME COMPLETED:
01:00 PM
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On 11/02/2022 Licensing Program Analyst (LPA) Arminder Singh arrived at facility to conduct a unannounced case management visit. LPA met with Licensee, Ileita Lafitte.

In today's visit there are 5 children present with Licensee's two fingerprint cleared Assistants.

This visit is in regards to delivering exclusion letter for the individual who is excluded from the facility and to verify the excluded individual is not present at the facility.

LPA toured the facility and verified the excluded individual in not present at the facility in today's visit. LPA was able to deliver the exclusion letter as well. LPA reminded Licensee that the individual may not be in contact with children and not be physically present in the facility.


There were no deficiencies in today's visit.

A notice of site visit was given and must remain posted for 30 days.

Exit interview was conducted and report was reviewed with the Licensee, Ileita Lafitte.





SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Arminder Singh
LICENSING EVALUATOR SIGNATURE: DATE: 11/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/02/2022
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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