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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 293602570
Report Date: 01/30/2023
Date Signed: 01/30/2023 12:07:15 PM

Document Has Been Signed on 01/30/2023 12:07 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, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:BROWN, FREDENEFACILITY NUMBER:
293602570
ADMINISTRATOR:BROWN, FREDENEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 320-2991
CITY:AUBURNSTATE: CAZIP CODE:
95602
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 10DATE:
01/30/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
11:40 AM
MET WITH:Fredene BrownTIME COMPLETED:
12:15 PM
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An unannounced plan of correction inspection was conducted today by LPA's Habtom and Blesi. The purpose of the inspection is to follow up on the deficiencies assessed on January 19, 2023.

The census for today was 10 day care children ages 4, 3, 2, 2, 2, 2, 1, 1, 1, 1 overseen by licensee Fredene Brown and her assistant. The licensee is in compliance with ratio and capacity at the time of inspection.

No Title 22 deficiencies were cited during today's inspection. Report was reviewed with licensee and notice of site visit was provided.


SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Lea Habtom
LICENSING EVALUATOR SIGNATURE: DATE: 01/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/30/2023
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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