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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423862
Report Date: 08/23/2023
Date Signed: 08/23/2023 04:39:00 PM

Document Has Been Signed on 08/23/2023 04:39 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
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:TARVER, CHRISTAFACILITY NUMBER:
013423862
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 6DATE:
08/23/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
02:35 PM
MET WITH:Christa TarverTIME COMPLETED:
03:45 PM
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Licensing Program Analyst (LPA) Diana Campos arrived at the facility and met with licensee Christa Tarver for a case management inspection to add an off-limit area of the home to the on-limits area for day care use. Present during the inspection was the licensee, her minor daughter and 6 children in care. LPA toured the areas of the home for a health and safety inspection. Licensee has requested to include the first level of the home which includes the kitchen and dining area as part of the on-limit areas to day care children. LPA observed a child proof gate at bottom of stairs to prevent access by children in care when downstairs. LPA did not observe any toxins or hazardous items accessible to children in care during today's inspection.
Dining area and kitchen are added to the on-limits areas of day care home during today's inspection.

Exit interview conducted and report reviewed with licensee Christa Tarver.
Notice of Site Visit was provided and must remain posted for 30 days.
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Diana Campos
LICENSING EVALUATOR SIGNATURE: DATE: 08/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/23/2023
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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