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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 173010643
Report Date: 04/24/2024
Date Signed: 04/24/2024 10:12:13 AM

Document Has Been Signed on 04/24/2024 10:12 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
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:WICHLAZ, HEATHER FCCHFACILITY NUMBER:
173010643
ADMINISTRATOR/
DIRECTOR:
WICHLAZ, HEATHERFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(707) 349-8981
CITY:LAKEPORTSTATE: CAZIP CODE:
95451
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
04/24/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Heather WichlazTIME VISIT/
INSPECTION COMPLETED:
10:20 AM
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Licensing Program Analyst (LPA) Sebastian Phouthavong arrived to conduct a change of location prelicensing inspection. An application was received to the department on 03/27/2024 for the change of location. An approved fire clearance was conducted 04/11/2024. Services will be available Monday - Friday, 6:00 AM - 6:00 PM. The licensee understands that 24hr consecutive care is prohibited. There are currently two adults living in the home.

During the inspection the home was toured inside and outside. The floor plan submitted by the licensee was reviewed and verified. The children will have access to the living room/playroom, 2 bedrooms, kitchen, dining area, hallway bathroom and front yard. The off-limits areas include master bedroom, basement/bedroom, garage, backyard and backyard dock. The off-limits areas of the home were made inaccessible by door locks, plastic doorknob covers and/or child gates.

There are no poisons in the home and the regulation that poisons are to be locked using a key or combination lock was reviewed. The firearms and ammunition are locked and separated from each other meeting requirements. LPA observed the fireplace to be barricaded and inaccessible to daycare children. There is a functioning smoke detector and carbon monoxide detector. The fire extinguisher is rated at 2A10BC. First aid supplies will maintained at the facility at all times. The home's yard is fully fenced. There were no pools or other bodies of water observed.

The facility is approved for licensure effective today, April 24, 2024

Exit interview conducted and report was reviewed with the Licensee, Heather Wichlaz.
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Sebastian Phouthavong
LICENSING EVALUATOR SIGNATURE: DATE: 04/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/24/2024
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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