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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343621825
Report Date: 09/08/2022
Date Signed: 09/08/2022 02:37:09 PM

Document Has Been Signed on 09/08/2022 02:37 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:BROWN, VANESSAFACILITY NUMBER:
343621825
ADMINISTRATOR:BROWN, VANESSAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 591-8082
CITY:SACRAMENTOSTATE: CAZIP CODE:
95828
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 6DATE:
09/08/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Brown, VanessaTIME COMPLETED:
02:50 PM
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 On 9/8/2022, at approximately 12:30pm, Licensing Program Analyst (LPA) Alize Tillery, arrived at the family child care home to conduct a case management inspection.

During today's visit, Licensee stated that she has attempted to contact her previous LPA to add the (side) backyard and front bedroom to "on limits" which currently reads as "off limits" on the license. Director stated she reached out prior to covid19 but had never heard back. LPA toured the back yard (side yard) and front bedroom; LPA did not observe any hazardous or toxic items.

Effective today, the backyard (side yard) and front bedroom is on limits. Effective today, the garage remains off limits.

LPA reviewed and provided the report to licensee, and provided a Notice of Site Visit to remain posted for 30 days.
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Alize Tillery
LICENSING EVALUATOR SIGNATURE: DATE: 09/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/08/2022
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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