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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343618629
Report Date: 11/27/2023
Date Signed: 11/27/2023 02:15:45 PM

Document Has Been Signed on 11/27/2023 02:15 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:TENNELL, ARLENEFACILITY NUMBER:
343618629
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 4DATE:
11/27/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Arlene TennellTIME COMPLETED:
02:30 PM
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On November 27th, 2023, Licensing Program Analyst (LPAs) Soleil Marx and Stephanie Piring, met with licensee, Arlene Tennell, for the purpose of a plan of correction inspection.

Licensee was cited on 11/21/2023 for being out of compliance with Title 22 Regulation, CCR 102416.5(c), the total licensed capacity for a Small Family Child Care Home shall not exceed eight children.
LPAs have cleared the citation after observing the Licensee in compliance with capacity requirements by having four children in care.

Licensee was additionally cited on 11/21/2023 for being out of compliance with Title 22 Regulation, CCR 102417(g)(5), All licensees shall ensure the inaccessibility of pools (in-ground and above-ground), fixed-in-place wading pools, hot tubs, spas, fish ponds and similar bodies of water through a pool cover or by surrounding the pool with a fence. LPAs observed that the pool was drained, however it was not dismantled or removed from the premises. A civil penalty is being cited for failure to correct the deficiency which was due 11/22/2023.

LPAs communicated to the seriousness of failing to correct this deficiency and informed the Licensee that civil penalties will accrue of $100 a day until corrected.

Exit interview and report reviewed with Licensee, Arlene Tennell. Notice of Site provided and must remain posted for 30 days. Appeal Rights provided





SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Soleil Marx
LICENSING EVALUATOR SIGNATURE: DATE: 11/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/27/2023
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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