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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343623145
Report Date: 08/09/2023
Date Signed: 08/09/2023 03:35:01 PM

Document Has Been Signed on 08/09/2023 03:35 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:CRUZ, GRISELDAFACILITY NUMBER:
343623145
ADMINISTRATOR:GRISELDA CRUZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 997-3283
CITY:SACRAMENTOSTATE: CAZIP CODE:
95824
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 3DATE:
08/09/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
03:20 PM
MET WITH:Griselda Cruz, LicenseeTIME COMPLETED:
03:45 PM
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
On August 09, 2023, Licensing Program Analyst (LPA) Eduardo Barragan met with Griselda Cruz, Licensee. The purpose of this visit was to clear a plan of correction that was issued on 07/25/2023, due to having a swimming pool that was not in accordance with Title 22 regulations.

LPA Barragan conducted a health and safety walk through of the home. LPA Barragan ensured that the home remained in compliance and that the licensee followed through with her plan of correction. The plan of correction was corrected. The citation is being cleared.

No citations are being administered during todays inspection.

A notice of site visit was given and must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

An exit interview was conducted. A copy of this report was provided to Griselda Cruz, Licensee.

SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Eduardo Barragan
LICENSING EVALUATOR SIGNATURE: DATE: 08/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/09/2023
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