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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423838
Report Date: 01/23/2023
Date Signed: 01/23/2023 09:42:18 AM

Document Has Been Signed on 01/23/2023 09:42 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, 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: 6CENSUS: 4DATE:
01/23/2023
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
09:13 AM
MET WITH:Ileita LafitteTIME COMPLETED:
09:46 AM
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On January 23, 2023 Licensing Program Analyst (LPA) Indira Loza arrived at the facility to conduct an announced Case Management visit for an Increase Capacity. LPA met with Licensee Ileita Lafitte. Present for the inspection were the Licensee, the Licensee's fingerprint cleared Assistant, two infants, and two Preschool-Age children.

The home is an apartment on the lower level of a duplex building. The home consists of three bedrooms, one bathroom, a kitchen, a dining area, and a living room. The Off Limit areas is the bedroom on the left from the hallway, and the kitchen. Applicant will ensure the off limit areas will be inaccessible by closed and/or locked doors, safety gates and visual supervision. The On Limit areas are the bedroom on the right from the entrance, the living room, dining room, the bathroom, and the bedroom at the end of the hallway, as well as the backyard which is used for outdoor play. The isolation area will be in the bedroom to the right from the entrance. There are two storage sheds in the backyard which are locked and inaccessible to children. There is a fully charged 3A40BC fire extinguisher, a working smoke detector, a working carbon monoxide detector, and a pull down alarm system.

The facility has been approved for a capacity Increase effective January 23, 2023.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE: DATE: 01/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/23/2023
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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