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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343620063
Report Date: 10/15/2021
Date Signed: 10/15/2021 08:54:58 AM

Document Has Been Signed on 10/15/2021 08:54 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME:MENDELSOHN, SARAH & LEA, MEGANFACILITY NUMBER:
343620063
ADMINISTRATOR:MENDELSOHN, SARAHFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 599-6749
CITY:ELK GROVESTATE: CAZIP CODE:
95758
CAPACITY: 14TOTAL ENROLLED CHILDREN: 8CENSUS: 3DATE:
10/15/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
08:18 AM
MET WITH:Sarah MendelsohnTIME COMPLETED:
09:00 AM
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On 10/15/2021 at 8:18 AM Licensing Program Analyst (LPA) Jeevun Birk-Miller conducted a case management inspection and met with Licensees, Sarah Mendelsohn and Megan Lea. There were two preschool age children and one infant in care. The purpose of the inspection was to inspect an inflatable spa located in the backyard. The spa has a tight fitting cover that has a lock on each strap. Licensee stood on top of the cover to demonstrate the cover could withstand the weight of an adult. Licensee agree to have supervision when around the spa.

Based on today's inspection, the Licensee's inflatable spa meets Title 22 regulation requirements. An exit interview was conducted and no deficiencies were cited at this time. A notice of site visit was given and posted. This shall be posted for 30 days.
SUPERVISORS NAME: Jeanne Smith
LICENSING EVALUATOR NAME: Jeevun Birk
LICENSING EVALUATOR SIGNATURE: DATE: 10/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/15/2021
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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