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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313624047
Report Date: 08/15/2023
Date Signed: 08/15/2023 09:00:31 AM

Document Has Been Signed on 08/15/2023 09:00 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:MYKITIN, RHIANNONFACILITY NUMBER:
313624047
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 5DATE:
08/15/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Rhiannon MykitinTIME COMPLETED:
09:15 AM
NARRATIVE
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Licensing Program Analysts (LPAs) Jeremey McClain and Pa Dao Vang conducted a Plan of Correction visit with licensee Rhiannon Mykitin. A census of five children was observed.

On 08/11/2023, Licensee was cited a Type A citation because LPA did not have access to confirm that weapons in the home were stored separately from ammunition.

During today’s inspection LPAs observed that weapons and ammunition are locked separate areas, and weapons were not loaded.

The deficiency is considered cleared. A letter of clearance was left with the licensee. No Title 22 violations are being cited during this inspection.

An exit interview was conducted with licensee, and a Notice of Site Visit was posted.
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Jeremey McClain
LICENSING EVALUATOR SIGNATURE: DATE: 08/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/15/2023
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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