<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313625283
Report Date: 11/07/2023
Date Signed: 11/09/2023 09:03:36 AM

Document Has Been Signed on 11/09/2023 09:03 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:GONZALEZ, ZAIRAFACILITY NUMBER:
313625283
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 1DATE:
11/07/2023
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Zaira GonzalezTIME COMPLETED:
10:00 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Gagandeep Singh met with the licensee, Zaira Gonzalez, for a case management inspection. During previous inspection on October 23, 2023, LPA observed that the licensee has swimming pool in the backyard. LPA observed that pool had fence toward the backyard and had locks on the windows, which lead toward the pool. After the inspection, Licensee has installed another fence next to the windows to completely enclose the pool. Purpose of today’s inspection was to ensure that the new fence meets the Department requirements and safety of the back yard.

During today’s inspection, LPA inspected the back yard and observed the licensee has installed a fence between the house and the pool, which enclose the pool area. By using measuring tape, LPA found that the new wall is five feet one inch high, which meets the Department’s requirement. The new fence does not has any door or gap in between. The new fence is secure to the ground using the metal bolts. LPA observed using the new fence, the pool can no be accessed from the windows in the living room.

During today’s inspection, LPA did not observe any hazard in the house and in the back yard. LPA observed the pool in the backyard is inaccessible for the children. Copy of this report was reviewed and provided to the licensee.

SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Gagandeep Singh
LICENSING EVALUATOR SIGNATURE: DATE: 11/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/07/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1