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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343618629
Report Date: 12/07/2023
Date Signed: 12/07/2023 01:33:00 PM

Document Has Been Signed on 12/07/2023 01:33 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: DATE:
12/07/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Arlene TennellTIME COMPLETED:
01:45 PM
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On December 7th, 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 previously 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 pool has been dismantled and removed from the premises. There are no bodies of water at the facility. LPA has cleared the deficiency.

Exit interview and report reviewed with Licensee, Arlene Tennell. Notice of Site provided and must remain posted for 30 days.
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Soleil Marx
LICENSING EVALUATOR SIGNATURE: DATE: 12/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/07/2023
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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